Objective: To investigate the dynamic performance of neuromyelitis optica(NMO) in serial magnetic resonance imaging(MRI) examinations. Materials and Methods: Five female patients with NMO(26.6±13.1 years old(range, 16~49 years old) were enrolled, their serial MRI data during the therapeutic and follow-up period were reviewed retrospectively. Result: All of the five patients with NMO had experienced visual impairment for one or more times, and segmental or diffused spinal cord lesion with edema(mainly affecting central gray matter) and slightly contrast-enhancement was demonstrated in their first MRI examination. In the first MRI examination, 2 patients with NMO also presented with optic chiasm swelling, thickening and mild contrast enhancement, with hypothalamus partly involved in one of them; one of these 5 patients presented with scattered small lesions in the brain. During the therapeutic and follow-up period, MRI demonstrated dynamic changes of spinal cord edema according to the illness conditions, probably with a migration of lesion location. Conclusion: NMO is a kind of recurrent, demyelinating disease mostly affecting optic nerve and spinal cord, MRI can provide reasonable basis for the clinical treatment by monitoring the dynamic changes of NMO lesions.