Knowledge of regional hemodynamics has widespread application for both physiological research and clinical assessment. Here we review the use of MR contrast agents to measure tissue perfusion. Two primary mechanisms of image contrast are discussed: relaxivity and susceptibility effects. Relaxivity effects result from dipolar enhancement of T1 and T2 rates. Because tissue T1 rates are intrinsically smaller, the dominant effect is shortening of T1 relaxation times. The second mechanism of image contrast is the variation in tissue magnetic field produced by heterogeneous distribution of high magnetic susceptibility agents. Quantitation of tissue perfusion requires a detailed understanding of the relation between contrast agent concentration and associated MR signal changes. Studies to date show a linear relationship between contrast agent concentration and rate change in most organs. The exact nature of this relationship in the dynamic setting of rapid contrast agent passage through the microcirculatory bed is less well established. If this relationship is known, tracer kinetic modeling can be used to calculate regional blood flow and blood volume. Data are presented which indicate that this approach is feasible, and suggest the potential of contrast-enhanced NMR for high resolution in vivo mapping of both physiology and anatomy.