OBJECTIVE To assess the feasibility of magnetic resonance voiding cystourethrography (MRVCUG) using MR fluoroscopy for evaluation of vesicoureteral reflux (VUR), and its use as a noninvasive alternative to standard VCUG. METHODS A total of 22 MR studies of 16 patients (five months to 41 years old) with primary VUR diagnosed by standard VCUG were evaluated. Six patients underwent MR studies and standard VCUG pre- and postoperatively. MR fluoroscopy was executed with a non-enhanced heavily T2-weighted single-shot fast spin-echo (FSE) sequence. The MR findings were correlated with those obtained by the gold standard, standard VCUG. RESULTS Of the 44 kidney-ureter units, 20 were refluxing on MRVCUG and 21 were refluxing on standard VCUG. There were one false-positive and two false-negative units. MRVCUG was 90% sensitive with a specificity of 96% for detecting VURs that were calculated based on kidney-ureter units. Two false-negative units were found in mild cases (grade I and II). For the units of grade III, IV, and V (high-grade reflux), MRVCUG detected all of the refluxing renal collecting systems. CONCLUSIONS MRVCUG can demonstrate high-grade reflux without ionizing radiation or catheterization.