Magnetic resonance (MR) diffusion imaging is a useful technique with which to increase our understanding of pathologic damage to the central nervous system. To fully quantitate diffusion and anisotropy in the spinal cord, as in other tissues, it is necessary to determine the diffusion tensor. If spinal cord diffusion is assumed to be cylindrically symmetric and the orientation of the cord in the gradient frame is known, then it is shown that full quantification is possible from only three images, two of which are diffusion-weighted. Mean diffusivity and volume ratio were determined in the normal cord of four healthy volunteers and in seven cord lesions of three patients with clinically definite multiple sclerosis (MS) who had locomotor disability suggesting the presence of spinal pathology. MS cord lesions exhibited increased mean diffusivity reflecting structural damage to the cord white matter. Quantification of diffusion and anisotropy using spinal cord diffusion imaging provides new structural information in relation to spinal cord pathology in vivo.