Background: Modic changes (MCs) are magnetic resonance imaging (MRI) signal alterations in the vertebral endplates and adjacent bone marrow, classified into types 1 (inflammatory), 2 (fatty), and 3 (sclerotic). Their prevalence and clinical significance, particularly in sub-Saharan African populations, are not well characterized and may be influenced by local demographic and biomechanical factors. Objective: To determine the prevalence, distribution, and demographic associations of Modic changes in patients with symptomatic degenerative lumbar spine disease at the Garoua Regional Hospital, Cameroon. Methods: A hospital-based cross-sectional study was conducted. Out of 418 lumbar MRI scans performed between January 2023 and June 2025, 121 patients with degenerative pathology were included. MCs were evaluated on T1- and T2-weighted sagittal images and classified according to the standard Modic system. Associations with age, sex, and occupation were analyzed using Chi-square tests in SPSS 20.0. Results: The overall prevalence of MCs in our symptomatic cohort was 48.3% (59/121). Modic type 2 was the most common subtype (25.7%), followed by type 1 (16.5%) and type 3 (6.1%). A highly significant gender-specific distribution was observed: Modic type 1 changes were significantly more prevalent in males (25.9% vs. 9.0%; p=0.005), while Modic type 3 changes showed a strong female predominance (11.9% vs. 1.9%; p=0.002). The most affected occupational groups were female traders and housewives. Conclusion: This study provides novel data on Modic changes in a West African population. Nearly half of symptomatic patients exhibited MCs, with a clear and significant gender disparity: an inflammatory pattern (Modic 1) associated with males and a sclerotic pattern (Modic 3) associated with females. These findings suggest potentially distinct pathophysiological pathways or risk factor exposures influenced by gender, possibly related to occupational biomechanics and hormonal factors. Rec