Fallopian tubes are symmetrical organs that extend from the uterine horn to the ovary, with the main function of transporting the oocyte to the uterine cavity for fertilization and implantation. A normal tube can be seen on MRI as a serpentine subtly enhanced para-uterine structure in intermediate T2 signal. Acute upper genital tract infections can be asymptomatic but can cause pelvic pain and sometimes lead to peritonitis with long-term consequences such as infertility and ectopic pregnancy due to subsequent adhesions. It usually begins with salpingitis, followed by pyosalpinx and tubo-ovarian abscess, which are well depicted on MRI. Atypical infections such as tuberculosis and actinomycosis can also affect the pelvis, displaying suggestive MRI features. Hydrosalpinx can occur after pelvic inflammatory disease. It can be, along with para-tubal cysts, a cause of isolated tubal torsion. Tubal endometriosis and myomas are rather rare. Ectopic pregnancy most commonly occurs in the ampullary portion of the tube. MRI should only be performed in that setting when there is doubt about the location of the gestational sac. Primary carcinoma of the tube is underestimated, likely due to its association with aggressive ovarian serous carcinoma. Its presentation on MRI can vary depending on the proportion of the solid component present.