This prospective multicenter study analyzes the image quality and incidence of undesirable side effects in 2543 film and 1133 intravenous digital subtraction angiographic (DSA) examinations with iopromide. It can be shown that the frequency of undesired side effects in both methods is twice as high in patients at risk as in patients without special risk factors. The most frequent side effects are gastrointestinal and, in cerebral angiography, of a central nervous system nature. The image quality for 99% of the film angiographies was good or better. It could be demonstrated for the DSA that a higher iodine concentration of 370 mg I/ml tends to result in a reduction of the image quality with an increased rate of side effects.