Over the last decade, three-dimensional contrast-enhanced magnetic resonance angiography (CE-MRA) has emerged as a widely accepted and powerful technique for diagnostic assessment of almost all vascular territories. Its non-invasive nature and lack of ionizing radiation, its potential to cover a large field of view and the safety of gadolinium-based contrast agents make CE-MRA an appealing alternative to digital subtraction angiography (DSA) or computed tomography angiography (CTA). However, recent reports linking high dose gadolinium-based contrast agents to the development of nephrogenic systemic fibrosis [1-3] have raised concerns over the safety of CE-MRA. As a result, many investigators have focused attention on gadolinium dose reduction strategies [4,5]. This article reviews existing state-of-the-art 3D CE-MRA strategies to reduce contrast dose and summarizes current applications and clinical experience to date. It also highlights evolving techniques, which the authors feel are likely to enhance the future impact of CE-MRA.