Recently, many research activities in medical diagnosis have been devoted to molecular imaging with MRI. A key issue is the evaluation of molecular targets that allow the early detection and characterization of diseases and the assessment of the effects of therapy. The majority of the current targeting vectors are peptides and proteins; reports on carbohydrate-based probes are relatively scarce. However, molecular recognitions involving carbohydrates are ubiquitous in both normal and pathological natural processes. Here, we critically review the literature on the development and validation of MRI probes using carbohydrates either as targets or targeting vectors. Exploitation of molecular recognition involving carbohydrates in MRI looks promising. Amplification techniques may be important for overcoming sensitivity problems.