Objective To evaluate the diagnostic value of non-enhanced magnetic resonance venography (MRV) for deep pelvic vein disease. Methods A total of 50 patients highly suspicious of pelvic and lower extremity vein disease were enrolled in the present study, and they were subjected to lower extremity vascular 2D-TOF MRV(two-dimensional time-of-flight MR venography)examination with the following technical parameter: echo time 5-7 ms, repetition time 35-45 ms, and flip angle 35°-45°. The MRV range included the scanning from low segment of inferior vena cava (IVC) to the popliteal vein (PV); the image quality was scaled into grades, and the results of MRV were compared with those of ultrasound and DSA. Results The images of all 50 patients clearly showed the scanning from low segment of IVC to the PV and its branches, with the diagnostic accuracy reaching 96.0%. The images of 25 patients clearly showed a total of 723 veins, including IVC, common iliac vein (CIV), internal iliac vein, external iliac vein (EIV), common femoral vein, deep femoral vein, superficial femoral vein and PV, with a consistent rate of 96.4%. Thrombosis from inferior segment of IVC to EIV was shown on MRV images of 9 patients, while it could not be clearly and completely manifested by B-ultrasound. Ten patients received DSA simultaneously, and the MRV results of 9 were in accord with those of DSA findings. MRV of one patient with thrombosis at initial segment of CIV was shown normal on DSA. Conclusion MRV for diagnosis of lower extremity vascular lesions has the advantage of non-trauma, greater scanning range, high grade contrast, excellent image delineation and intuitive convincement, making it worth popularizing in clinic.