T1-weighted images after the injection of Gd-DOTA, a new paramagnetic contrast medium, were compared with non-enhanced T2-weighted images in 42 consecutive cases of musculoskeletal pathology. In addition we evaluated the incidence of side effects. Enhanced T1-weighted images were superior in depicting the various parts of a lesion and the borders between the lesion and normal tissue or perifocal reaction. On the other hand the non-enhanced T2-weighted images better depicted the border between the perifocal reaction and normal tissue. In aggressive lesions, especially in malignant tumours, the two sequences are complementary. Enhanced T1-weighted images did not contribute significantly to assessing benign lesions. The incidence of side effects was acceptable and no severe reactions occurred.