Hematological malignancies are tumors of the bone marrow and lymphatic system cells. Leukemia, Lymphoma, Multiple Myeloma and Plasmacytoma are the most common entities of this group. These tumors frequently cause spinal lesions, which can be the first manifestations of the disease. In this setting, Magnetic Resonance and Computed Tomography may be useful to characterize these lesions. Aim of this review is to describe the main spinal imaging findings of Leukemia, Lymphoma, Multiple Myeloma and Plasmacytoma.