Jochen Walz, MD, from the Paoli-Calmettes Institute, Marseille, France, discusses the limitations of magnetic resonance imaging (MRI) in prostate cancer diagnosis at the European Association of Urology (EAU) conference 2017 in London, UK. He explains that MRI can be used as a triage test in patients with suspicion of prostate cancer who have not yet had a diagnostic workup for prostate cancer. Some studies have described that if an MRI is negative in this case, there is no need to worry about the presence of significant cancer, while others have observed that significant cancer can be missed when using this approach. A further very important limitation of MRI is related to the quality of this sophisticated technique. Current initiatives to overcome this limitation include the development of a certification process together with the European Society of Urogenital Radiology to establish standards for centers which carry out MRI-based diagnosis for prostate cancer.