Background: Low back pain (LBP) is a prevalent condition, with lumbar prolapsed intervertebral disc (PIVD) being a significant cause of radiculopathy and disability, especially in working-age individuals. PIVD results from disc degeneration or mechanical stress, often affecting the L4–L5 and L5–S1 levels. Clinical symptoms include radiating leg pain, sensory loss, and weakness. While neurological examination is essential, imaging, particularly Magnetic Resonance Imaging (MRI), is the gold standard for diagnosis. MRI must be interpreted alongside clinical findings, as disc abnormalities may appear in asymptomatic individuals. Correlating MRI features with clinical symptoms is crucial for accurate diagnosis and management. Aim of the study: The present study aims to evaluate and correlate the clinical and MRI findings among patients presenting with lumbar prolapsed intervertebral disc at a tertiary care hospital. Methodology: This hospital-based descriptive cross-sectional study was conducted over six months, from January to June 2022 in the Dept. of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh. Fifty patients aged 18–70 years with low back pain, with or without radiculopathy, who underwent MRI, were enrolled using purposive sampling. Clinical evaluation included neurological examination, pain scoring (VAS), and straight leg raising (SLR) tests. MRI findings were analyzed for disc herniation level, type, and associated features. Data were collected using a structured sheet and analyzed using SPSS version 26.0. Descriptive statistics and chi-square tests were used to assess the correlation between clinical and MRI findings. Results: Among 50 patients, most were aged 31–50 years (68%) and male (64%), with 62% overweight/obese and 56% smokers. All presented with low back pain; 80% had radiculopathy, mainly right-sided (40%). Numbness and motor weakness were noted in 70% and 32%, respectively, with a mean VAS score of 6.9 ± 1.8. MRI revealed L4–L5 (48%) and L5–S1 (36%) as the most affected levels, with protrusions (42%) and paracentral herniations (56%) common. Nerve root compression was seen in 76%. Radiculopathy correlated with compression in 95%, and 85% of positive SLR cases matched MRI findings, confirming a strong clinical-radiological correlation. Conclusion: There was a significant correlation between clinical features and MRI findings of disc prolapse, consistent with findings from similar studies. However, not all imaging abnormalities corresponded to clinical symptoms, emphasizing the importance of correlating radiological findings with clinical evaluation for accurate diagnosis and management.