Based on a MEDLINE search, we present the current status of magnetic resonance arteriography (MRA) and peripheral vascular surgery. Non-enhanced MRA (TOF-MRA) is more time-consuming than is gadolinium-enhanced MRA (CE-MRA), and the gadolinium-enhanced technique seems to perform more accurately and pose fewer problems. The sensitivity and specificity of TOF-MRA are 93% (range 64-100%) and 88% (range 57-100%) respectively, and that of CE-MRA 96% (range 71-100%) and 96% (63-100%), respectively, with conventional arteriography as the gold standard. Some studies report an incidence of run-off vessels suitable for distal bypass that are visible on MRA, but invisible on conventional arteriography. Gadolinium contrast is given intravenously and is not nephrotoxic. CE-MRA is accurate, compared to conventional arteriography, has the potential to increase the limb salvage rate for selected patients, is non-invasive, and well tolerated.