Dynamic contrast-enhanced magnetic resonance imaging is a useful clinical tool in evaluation of soft tissue neoplasm and lymph nodes in head and neck. It is thought to be a useful predictor of response to radiotherapy for head and neck carcinoma and used to monitor the treatment and distinguish post-therapeutic changes from recurrent mass with greater confidence. It can be used to distinguish between normal and malignant tissue and to differentiate a malignant lymphoma from other lymph nodal enlargements. The technique utilizes relative differences in microvasculature and microcirculation between malignant and non-malignant tissue to achieve greater contrast in signal imaging following bolus contrast administration. This article explains the underlying principles and imaging techniques for this new diagnostic tool. The clinical applications and technical challenges are discussed. The future challenges and some contradictions in results are also outlined.