Comparison between Gadolinium Enhanced Susceptibility Weighted Imaging and Conventional T1-Weighted Imaging in Optimizing the Recognition of Active Plaques of Multiple Sclerosis Background: The Gd-SWI sequence is a new important magnetic resonance imaging sequence that has been applied currently due to its ability to optimize the recognition of active plaques of MS and has a higher accurate performance than gadolinium T1WI that is currently used in clinical practice. The aim of this study is comparing the performance of the Gd-SWI sequence with the performance of other used sequences in clinical practice in detection of blood brain barrier (BBB) dysfunctions in MS plaques. Methods: In this retrospective study, Twenty four patients were involved (16 females and 8males, their age ranging from 20- 42 years with the mean age 26.33 years), they were divided into two groups: 8 active cases and 22 inactive cases clinically and radiologically proven MS cases for MRI diagnosis and follow up. Results: Two thirds of the studied group (66.7 %) had inactive lesions and one third (33.3 %) had active ones with (12.5 %) of both active and inactive lesions were progressive. There was higher ability of post-contrast SWI to demonstrate active plaques than post-contrast TIWI and there was highly statistically significance and good agreement (kappa=0.71) with 89.5% percent of agreement between post contrast enhanced lesions by SWI and T1 and statistically highly significant difference (p<0.001). Conclusions: Gadolinium –SWI technique improved detection accuracy of MS- contrast-enhanced plaques better than Gd-T1 SE, including their locations and morphologies. Keywords: Susceptibility Weighted Imaging, Multiple sclerosis, Magnetic Resonance Imaging, T1WI.