The use of gadolinium-based contrast media in pregnant or lactating women has been discouraged at many radiology departments due to the lack of knowledge of the risks for the fetus and the unwillingness to expose neonates to unnecessary drugs. In the present review the current literature and present guidelines regarding the use of gadolinium-based contrast media have been reviewed to validate the justification for their administration to pregnant or lactating women and small children. J. Magn. Reson. Imaging 2011;. © 2011 Wiley-Liss, Inc.