High field magnetic resonance imaging at 3.0 T is rapidly gaining clinical acceptance as the preferred platform for magnetic resonance (MR) imaging. This is spurred in part because advances in the manufacture of magnet technology have brought the cost of 3.0-T magnets into the range of previous 1.5-T machines, as well as ongoing research demonstrating numerous advantages of 3.0 T over 1.5 T in neurological imaging. Many factors are responsible for improved imaging at higher field strength, including increased signal-to-noise and contrast-to-noise ratios. The impact of 3.0-T imaging of the musculoskeletal system has been less dramatic because its optimization is more complicated in the musculoskeletal system than in the brain. Many issues must be considered beyond what might be expected from simply doubling the field strength, including hardware design, protocol modifications because of changes in tissue characteristics at higher fields, artifact reduction, and safety. This article addresses many of these concerns, focusing on techniques to optimize high field MR imaging of the musculoskeletal system.