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Objective To determine the value of pelvic MRI for assessing the gonads in complete androgen insensitivity syndrome (CAIS). Methods The clinical data and pelvic MRI of 10 men with CAIS diagnosed by clinical, imaging and surgical pathology were retrospectively analyzed. Results 9 patients underwent gonadectomy, and 1 patient underwent vulvoplasty with gonads temporarily retained. Of the 18 pathologically confirmed testes, 8 were located above the internal inguinal ring, 5 in the subcutaneous space of the inguinal canal, 3 in the iliac fossa, and 2 medial to the external iliac vessels. Eight testes contained tumors including highly differentiated sertoli-leydig cell tumors (4), sertoli cell tumors (2), highly differentiated sertoli-leydig cell tumor with seminoma and fibroma (1), highly differentiated sertoli-leydig cell tumor and fibroma (1). Three testes showed mesonephric duct cysts. Bilateral ectopic testicles were observed on MRI in all 10 patients. The 10 testes without tumors were well-defined with uniform Tt isointensity, uniform slight hyperintensity on T2- and diffusion-weighted images, and uniform contrast enhancement. Of 8 testes with sex cord stromal tumor and/or seminoma, 4 were homogeneous slightly T2 hyperintense and 4 were heterogeneous with internal nodular low signal. All 8 lesions manifested heterogeneous nodular or septal enhancement. No uterus and bilateral appendages were noted in all 10 patients. Inferior vagina was found in 9 patients. Conclusion MRI can delineate the location of ectopic testis and any associated tumor in CAIS. [ABSTRACT FROM AUTHOR]