Background: Peripheral nerve pathologies are commonly encountered by clinicians in practice. The present study was conducted to compare MRI and HRUS in detection of peripheral nerve pathologies. Materials & Methods: 65 cases of peripheral nerve pathologies of both genders underwent HRUS with 14 MHz linear-transducer and 3 or 1.5T MR. The accuracy, sensitivity, and specificity of these modalities compared with the diagnostic standard determined by surgical and/or histopathological. Results: Out of 65 patients, males were 35 and females were 30. Nerve discontinuity was detected by 78% in MRI and 100% in USG, increased nerve signal in 100% and 70%, fascicular change in 89% and 100%, caliber change in 56% and 100%, neuroma/mass lesion in 90% and 100% in MRI and USG respectively. The difference was significant (P< 0.05). MRI and USG showed sensitivity of 92% and 82%, specificity of 67% and 100%, PPV of 95% and 100%, NPV of 58% and 42% and accuracy of 90% and 83% respectively. Conclusion: HRUS is a powerful tool that may be used as the first-line imaging modality for the evaluation of peripheral nerve pathologies.