Objective: To observe the diagnostic advantages of MR diffusion-weighted imaging (DWI) integrated with dynamic contrast-enhanced (DCE) technology in ankylosing spondylitis (AS) with sacroiliac joint lesions (SIJ). Methods: 58 patients with AS-SIJ were selected and diagnosed with conventional MRI and DWI integrated with DCE, respectively, and the diagnostic differences were compared. Results: During the diagnosis of patients with AS-SIJ, the disease was graded. The detection rate of grade 1 was higher with DWI integrated with DCE, while there was no difference in the detection rates of the other grades between the two techniques. The detection rates of bone marrow edema, bone cystic changes, and L5-S1 articular process lesions were higher with DWI integrated with DCE. There was no difference in adverse reactions between the two diagnostic techniques. Conclusion: DWI integrated with DCE technology has a high early detection rate for AS-SIJ. It is recommended to use DWI integrated with DCE technology as the preferred diagnostic scheme to improve diagnostic accuracy.