Both Ionic and non-ionic radiographic contrast for intravascular use are FDA approved as pharmaceuticals and have been on the market in the United States (U.S.) for many years. The vast majority of procedures using intravascular contrast has transitioned to non-ionic due to a reduction in adverse reactions. The non-ionic low osmolar agent Iopamidol (Bracco Isovue) was approved 1985 and Iohexal (GE Omnipaque) in 1995. The iso-osmolar agent Iodixanol (GE Visipaque) was FDA approved in 1996. The following is an overview of the market and evidence related to use of radiographic contrast and guidelines from the American College of Radiology. This document provides an overview of these products and current evidence regarding their use.