This review focuses on exogenous MRI contrast agents that are responsive to enzyme activity. Enzymes can catalyze a change in water access, rotational tumbling time, the proximity of a 19F-labeled ligand, the aggregation state, the proton chemical exchange rate between the agent and water, or the chemical shift of 19F, 31P, 13C or a labile 1H of an agent, which can be used to detect enzyme activity. The variety of agents attests to the creativity in developing enzyme-responsive MRI contrast agents.