Magnetic resonance angiography (MRA) is a recently developed, noninvasive vascular imaging technique. The authors of this investigation assessed the diagnostic value of MRA, along with its influence on therapeutic decisions, in 11 patients with a variety of head and neck disorders. In 5 patients, MRA diagnosed or ruled out an intrinsic vascular lesion. MRA was used to evaluate 5 of 8 patients with cancer for evidence of direct tumor involvement of vascular structures. Other uses of MRA included preoperative determination of tumor vascularity and delineation of anatomic relationships between normal vessels and head and neck pathology. Overall, MRA results guided management in 10 patients, and in some cases it determined the extent of surgical intervention. Because MRA is safer and more practical than traditional angiography, the authors recommend more frequent use of this imaging technique in the practice of head and neck surgery.