Magnetic resonance imaging has enjoyed some truly amazing advancements in recent decades, but it’s also endured some concerning challenges. One of the most significant controversies is the debate on the toxicity of gadolinium-based contrast (GBC), especially in light of recent evidence of its deposition and retention in patients with normal renal function. Claims that this has led to patient harm have increased, and sparked considerable media attention. It’s incumbent upon responsible medical imaging teams to stay current on the evidence-based data as the issue evolves, and remain open to all points of view in this debate. This course attempts to explore the various elements of the debate and encourage ongoing conversation, which is fundamental in achieving the best outcomes.