•Dynamic signal changes are seen on MRI after focal cryotherapy for prostate cancer.•Most lesions show hyperintensity at 3 months post-treatment on T2WI, T1WI, and DWI.•All lesions show hypointensity after 17 months on T2WI, T1WI, and DWI.•Peripheral enhancement is often observed and disappears after 23 months on DCE-MRI.•Transient internal enhancement may be observed in the early post-treatment period. To evaluate the time-course changes of multiparametric MRI findings following focal cryotherapy for localized prostate cancer. Sixteen patients who underwent focal cryotherapy as an initial curative treatment for localized prostate cancer during March 2017–April 2021 were included. Before the treatment, the patients underwent targeted prostate biopsy using MRI–transrectal ultrasound fusion. Overall, 64 MRIs were conducted after focal cryotherapy and the temporal post-treatment MR signal changes of the ablated area in T2WI, T1WI, DWI, and DCE-MRI were analyzed. Technical success was achieved in all patients. The median follow-up period was 22 months. The initial post-treatment MRI revealed significant signal changes in the target lesions for all patients, including the disappearance of findings suggestive of cancer. At 3 months post-treatment, most lesions were hyperintense with a hypointense rim on T2WI, T1WI, and DWI (83.3 %). After 6 months, hyperintensity reduced, and after 17 months, all lesions showed hypointensity in these sequences. DCE-MRI of most patients showed loss of internal enhancement; however, one patient exhibited residual nodular enhancement in the ablated area at 3 months, which disappeared after 6 months. Peripheral enhancement was common at 3 months, disappearing after 23 months. Two patients showed biopsy-evidenced local recurrence. The recurrent lesions showed hypointensity on T2WI with diffusion restriction and early contrast enhancement in the ventral transition zone. MRI findings of the ablated sites following focal cryotherapy for localized prostate cancer show dynamic signal changes, especially within the first 6 months.