Breast MRI is a powerful imaging tool with an excellent sensitivity around 94-100%, especially when double read, to detect cancers which are otherwise occult. However, lower specificity and high false positivity rates, demands histological confirmation of MRI only detected lesions to prevent possible over treatment. In order to maintain high standards and cost effectiveness of breast MRI, careful patient selection is as important as maintaining a meticulous technique or radiologist expertise. Breast MRI is useful at every phase of breast cancer management such as early detection, pre-operative staging, monitoring neo-adjuvant chemotherapy and identifying recurrences. This is a review on current best practice, for clinical applications of breast MRI.