Objective: The purpose of this study is to Correlate the characteristic pattern of lesions affecting posterior horn of medial meniscus in MRI with Arthroscopic findings and calculate sensitivity, specificity and accuracy in diagnosis of ramp lesions. Methodology: It is a 2-year prospective study conducted in department of orthopedics, Rajarajeswari Medical college and Hospital, Banglore. Patients who were diagnosed with meniscal injuries were posted for arthroscopy surgery after obtaining the informed consent. In this study we compared MRI findings with arthroscopic findings of medial meniscal ramplesions of knee. The data is prepared and sensitivity, specificity, accuracy of MRI were calculated. Results: A total of 112 patients of knee injuries were evaluated in which the Medial meniscus was injured in 64.96% of cases. The MM tear with ramp lesion was present in 26(65%) cases, of which 5 (12.5%) cases had grade I tear, 8 (20%) cases had grade II tear and 13 (32.5%) cases had grade III tear. The sensitivity, specificity, PPV and NPV were calculated and we found Sensitivity 88.89%, Specificity 84.62%, Positive predictive value 92.31%, Negative predictive value 78.57%, Accuracy 87.50%. Conclusions: The Meniscal Ramp lesions need to evaluation of the knee injuries accurately is very crucial for the proper management and outcome. MRI shows moderate sensitivity, specificity and accuracy in the diagnosis of ramp lesions in posterior horn of medial meniscus with more false positives and false negative values. Common causes of false positive findings in MRI is due to misinterpretation of intra meniscal signal changes (grade II signal changes) or normal anatomy as tears. The arthroscopic evaluation of ramp lesions was done using a postero-medial and trans-notch view and other accessory portals