Four-dimensional time-resolved MR angiography (4D-MRA) using keyhole imaging techniques is a new method of performing contrastenhanced vascular imaging. Combining parallel imaging and keyhole imaging techniques, it is possible to obtain dynamic MRA scans up to 60 times faster, thereby achieving subsecond sampling of the contrast hemodynamics. Furthermore, imaging at 3 T gives higher signal, thus affording higher spatial resolution and allowing dynamic 3D MRA to approach the diagnostic performance of conventional digital subtraction angiography. This article presents the authors' clinical experience using 4D-MRA to evaluate various vascular abnormalities in the brain, spine, orbits, and neck at 3 T, demonstrates the imaging findings of this novel technique, and discusses its advantages and use in current neuroradiology practice.