We will review the current recommended imaging parameters to achieve consistent high-quality head/neck contrast-enhanced MRA at both 1.5T and 3.0T. Discuss the utilization of clinical MPRAGE and 3D FSE T1W sequences to detect intraplaque hemorrhage and possibly necrotic core at the carotid bifurcation. Review how this additional vessel wall imaging affords better risk stratification of future stroke than carotid stenosis measurements. Discuss the rapidly evolving intracranial vessel wall imaging (IC VWI) techniques which are currently obtained with works-in-progress investigational sequences. Early implement has documented the potential added value of IC VWI to identify specific etiologies of proximal intracranial arterial narrowing.