Compared to routine spin-echo images, contrast-enhanced MR angiography provides improved characterization of the spinal vasculature. This technique can help narrow the differential diagnosis and guide further treatment in patients with radiculopathy or myelophathy. The most useful application to date has been in screening for spinal dural fistulae. The fast, three-dimensional method offers the possibility of distinguishing the largest spinal arteries and veins, although additional technical improvements and clinical experience are needed to accomplish this goal.