Magnetic resonance imaging (MRI) is increasingly used in autosomal dominant polycystic kidney disease (ADPKD) for diagnosis, classification, assessment of disease progression and treatment response, and for identifying complications. Herein we review the role of MRI in the management of patients with ADPKD. We show how MRI‐derived total kidney volume is a biomarker for assessing ADPKD severity and predicting decline in renal function. We also demonstrate the MR appearances of common complications.Level of Evidence: 3Technical Efficacy Stage: 5J. Magn. Reson. Imaging 2019;50:41–51.