Radiological procedures utilizing intravascular iodinated contrast media are being widely applied for both diagnostic and therapeutic purposes and represent one of the main causes of contrast-induced nephropathy (CIN) and hospital-acquired renal failure. Due to the lack of any effective treatment, prevention of this iatrogenic disease, which is associated with significant in-hospital and long-term morbidity and mortality and increased costs, is the key strategy. However, prevention of CIN continues to elude clinicians and is a major concern during percutaneous coronary interventions (PCI), as patients undergoing these procedures often have multiple comorbidities. The purpose of this article is to examine the pathophysiology, risk factors, and clinical course of CIN, as well as the most recent studies dealing with its prevention and potential therapeutic interventions, especially during PCI.