Nephrogenic systemic fibrosis (NSF) is a recently characterized systemic fibrosing disorder occurring in patients with underlying renal disease. This condition principally leads to skin thickening and hardening and may induce joint immobility and inability to walk. In 2006, clusters of NSF were associated to an exposure to gadolinium containing contrast agents during magnetic resonance imaging. Gadolinium has been detected in skin tissue of patients with NSF. Gadodiamide, a linear gadolinium chelate appears to be particularly at risk. During renal failure, gadodiamide accumulation may explain the development of NSF. Regulatory decisions have been taken to contraindicate gadodiamide in patients with severe renal impairment.