PURPOSE: To determine the role of MR contrast enhancement in evaluating time course of brainstem infarction. MATERIALS AND METHODS: MR imaging with IV administration of gadopentetate dimeglumine was retrospectively reviewed in 43 patients with clinically and radiologically documented brainstem infarctions. The of infarction was classified into spotty and patchy. Presence of parenchymal enhancement in infarction evaluated. RESULTS: By location, there were 34 pontine, 3 midbrain, 6 medullary infarctions. The age of the infarctions ranged from 1 day to 9 months, with 5 patients scanned within 3 days and 10 scanned within 2 weeks of clinical ictus. Abnormalities on T2-weighted images were encountered in every case, with spotty pattern in 14 cases and patchy pattern in 29 cases. Parenchymal contrast enhancement was seen in 9 cases(20%), primarily occurring between days 8 and 20. CONCLUSION: MR contrast enhancement in brainstem infarction was infrequent that it may not be useful in of the age of infarction.