Nephrogenic systemic fibrosis (NFS) is a relatively newly discovered disease, which has been reported in patients with renal failure. NSF usually develops after exposure to Gadolinium (Gd) based contrast media, which are used in magnetic resonance (MR) studies. Nephrogenic systemic fibrosis has both cutaneous and deep, visceral manifestations, involving muscles, lungs, heart and more. The course of NFS is usually progressive, with no effective treatment reported, except for renal function improvement. Awareness to NFS is important not only for early diagnosis of affected patients, but also in preventing new cases. According to current FDA guidelines for imaging patients with renal failure, use of CT with iodinated contrast media is preferred in patients with renal failure, over MR studies with Gd in patients with renal failure.