Summary
For more than 10 years it has been believed that gadolinium‐based contrast agents in doses used for magnetic resonance imaging (MRI) are relatively safe with regard to acute non‐renal and renal adverse reactions and delayed reactions. However, recent observations have shown that it may not be the case in patients with reduced renal function as gadolinium‐based contrast agents may trigger the development of fibrosis in all parts of the body so‐called nephrogenic systemic fibrosis (NSF). Its primary predilection is the skin. Unrelated to the development of NSF, contrast‐induced nephropathy may occur after administration of gadolinium‐based contrast agents. The current review updates the recent developments regarding the severe delayed reaction. However, the fear of NSF should not lead to a denial of a well‐indicated enhanced MRI examination.