Intracranial vessel wall magnetic resonance imaging (VW-MRI) can be a useful diagnostic technique in patients with ischemic stroke and subarachnoid hemorrhage. Unlike conventional vascular imaging that depicts only the vessel lumen, VW-MRI allows visualization of pathology in the arterial wall itself. The ability to image the arterial wall is useful, as many pathological processes reside within the wall and only secondarily affect the lumen. In this review, we will present 6 clinical uses for intracranial wall imaging to highlight the versatility of this technique.