Introduction: Finding the cause of seizures has always been one of the most important problems for physicians. Magnetic resonance imaging (MRI) imaging in patients with seizures is one of the most important imaging modalities in detecting the structural abnormalities in seizures. Therefore, the aim of this study was to evaluate the prevalence of abnormal findings in the MRI of patients with the first episode of seizure. Materials and Methods: This descriptive cross-sectional study was performed on patients referred to two imaging centers with (3T trio Siemens and 1.5T Avanto) with the first episode of seizure. Initially, the report of clinical diagnostic measures and demographic characteristics as well as clinical history, neurological examination and then MRI report were collected in a special checklist. MRI was performed by two MRI machines (3T trio Siemens and 1.5T Avanto) with dedicated protocol of seizure. After data collection, analyzing the data by SPSS software version 19 was performed and final results were extracted. Results: A total of 1576 patients with a mean age of 30.1 years were evaluated, of whom 776 (49.2%) were female. The type of seizure was generalized in 1478 patients (93.8%) and focal in other patients. Abnormal findings were detected inMRI images of 619 patients (39.3%), the most common of which were temporal sclerosis in 193 patients (12.2%) and scar and gliosis in 117 patients (7.4%). The most lesions were found in the temporal lobe of 265 patients (45.5%). The frequency of normal and abnormal MRIs were significantly different between the sexes (P = 0.011), between different age groups (P <0.001) and also between focal and generalized seizures (P <0.001). Conclusion: Regarding to importance of MRI with dedicated protocol in detection of structural abnormalities in seizure ,we tried to perform demographic study and categorizing the structural abnormalities in a large number of cases to prove roleof MRI even in the first attack of seizure and also to emphasis on importance of early MRI on diagnosis and management of cases .However further investigation are needed to evaluate the role of MRI as the early imaging modality even in the first attacks seizure cases ..