Objective To explore the diagnostic value of magnetic resonance imaging (MRI) combined with serum levels of galactin-1 (Gal-1) and galactin-3 (Gal-3) for early rheumatoid arthritis (RA). Methods A total of 118 early RA patients admitted from February 2022 to February 2024 were selected as the early RA group, 120 patients with benign arthritis were selected as the benign arthritis group during the same period, and 100 healthy individuals were selected as the control group. The general information of the examinee was collected. Enzyme linked immunosorbent assay (ELISA) was applied to detect serum Gal-1 and Gal-3 levels. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic value of serum Gal-1 and Gal-3 levels for early RA. Both the early RA group and the benign arthritis group underwent MRI testing, using the American College of Rheumatology (ACR) as the gold standard, the consistency between MRI combined with serum Gal-1 and Gal-3 levels and ACR diagnosis of early RA was detected by Kappa test.Results The serum levels of Gal-1 and Gal-3 in early RA patients were higher than those in the benign arthritis group and control group (P＜0.05). ROC curve results showed that the area under the curve (AUC) of Gal-1 for diagnosing early RA alone was 0.820 (95%CI:0.765-0.866), with a cutoff value of 57.506 ng/mL. The AUC of Gal-3 for diagnosing early RA alone was 0.812 (95%CI: 0.756-0.859), with a cutoff value of 1.725 ng/mL. The consistency test between the combination of MRI, serum Gal-1 and Gal-3 levels with ACR (Kappa value=0.832) was higher than that of MRI alone (Kappa value=0.733). The sensitivity and negative predictive values of serum Gal-1 and Gal-3 levels in diagnosing early RA patients were higher than those of a single indicator, and the missed diagnosis rate was lower than that of a single indicator (P＜0.05).Conclusion Early RA patients have elevated serum Gal-1 and Gal-3 levels, and MRI combined with serum Gal-1 and Gal-3 levels has better diagnostic efficacy in early RA