There is no evidence in the literature of harmful effects of MRI on the fetus and therefore no specific special considerations are needed once an attending radiologist has deemed the MRI study to be warranted. Such a decision should rely on a discussion with the referring physician and a careful review of pre-MRI data that clearly demonstrates its need. In general, fetal MRI has limited utility prior to 16-18 weeks due to the small size of the fetus and incomplete organogenesis and therefore should be performed sparingly in the first trimester. The literature does, however, maintain several important safety questions regarding fetal exposure to electromagnetic and sound energy for which the currently available data remains inconclusive. Continued studies are warranted that more definitively address all embryonic and fetal safety concerns related to MRI.