The novel coronavirus disease (COVID-19), which was accepted as a pandemic by the World Health Organization (WHO) in 2020, has affected millions of people all over the world and caused deaths. Examining the pathophysiology of radiological lesions is perhaps the key in understanding this endless disease for which early diagnosis is crucial due to its high contagiousness. Considering that individuals with mild or even asymptomatic COVID-19 can significantly increase the transmission in the society, early diagnosis is crucial in the fight against the pandemic. Although RT-PCR is the first method of choice for diagnosis, when the studies are reviewed, imaging methods that provide faster results in diagnosis come to the fore, especially in clinically severe cases, since RT-PCR and lung imaging do not have a clear advantage over each other and even they help in diagnosis. At this point, understanding the pathogenesis of these pathological formations detected on imaging may play a key role in this broad disease. In this article, the background pathophysiology of radiological imaging, which is important to us, clinicians, has been discussed in the light of the current Iiterature review.