This article discusses the current status of clinical feasibility testing and outlines some of the advantages and disadvantages of contrast-enhanced breast MR imaging. A review of imaging parameters includes the dose of paramagnetic contrast agents, two- versus three-dimensional scanning, and postprocessing data analysis with an emphasis on areas for further development. Principles of interpretation for normal tissue, benign lesions, and invasive cancers are summarized including causes of false-positive and false-negative MR imaging interpretations. Future clinical roles for breast MR imaging such as MR imaging-directed biopsies and therapies and MR as a complementary technique to film-screen mammography for selected clinical situations are suggested.