Introduction: The clinical need to diagnose sacroiliitis at an earlier stage has led to the sacroiliac joints being more frequently imaged, particularly with magnetic resonance imaging (MRI). This review outlines the imaging approach to sacroiliitis, emphasizing the imaging protocols, diagnostic criteria, limitations and potential mimics of MRI examination. The value of imaging-guided intervention in sacroiliac joint disease is also briefly outlined. Materials and Methods: This is a prospective, observational and descriptive study conducted in the Department of Radiodiagnosis, Subbaiah Institute of Medical Sciences from June 2020 to November 2020. Treatment naive patients with low back pain and subsequently diagnosed with Inflammatory Low Back Pain (LBP) as per Calin criteria were identified. The clinical and laboratory parameters of these patients were recorded. Sacroiliac Joint Dysfunction (SIJ) radiographs of these patients were analyzed. Results: Seventy patients were registered with 35 of subjects being female and 35 males. No significant difference was noted in the age of onset or duration of illness in males and females. HLA-B27 positivity was noted in only 9.6% subjects whereas 63.4% of subjects had negative HLA-B27 status. There was no significant difference in the positivity of this gene in male (5.7%) and female (5.7%) groups. Borderline HLA-B27 status was commoner in males (21.1%) than females (7.6%). About 31.4% of cases demonstrated active inflammation (raised CRP levels) at presentation. A maximum number of cases were seen in Grade 2, followed by Grade 3. Cases with symmetrical sacroiliitis were more (27.1%) as compared to asymmetrical/unilateral sacroiliitis. HLA-B27 positivity in symmetric cases was 15.7% as against 11.4% in asymmetric cases. Conclusions: In the present scenario, where the majority of cases are presenting in the chronic stage of the disease, radiography may be advocated in resource poor areas to decrease burden and cost related to