Studies suggest that magnetic resonance (MR) imaging may have a variety of roles in the detection and management of breast disease. However, because study methods and imaging techniques are not standard, there is still a great deal of uncertainty about its place in clinical practice. The authors review the current state of breast MR imaging and address a number of issues, including the basis for contrast material-enhanced imaging, techniques, and possible clinical roles, including treatment planning, evaluation of the posttreatment breast, evaluation of breast implants, characterization of breast masses, MR imaging-guided biopsy, and the potential for cancer screening. Although it is premature to recommend the routine use of breast MR imaging, contrast-enhanced MR imaging has potential as a comprehensive platform for the detection, localization, biopsy, and treatment of breast cancers.