Contrast media are medicinal solutions enhancing diagnostic radiology's imaging quality by distinguishing anatomical structures. These widely used exams involve pharmaceutical agents, yet adverse reactions can arise. This study targets primary risks and adverse reactions tied to major contrast media in radiology. It assesses current concepts and protocols to minimize these reactions. Techniques for contrast-enhanced images demand element-based substances: iodinated, barium-based, and gadolinium-based contrasts. Adherence to manufacturer's guidelines and implementing prevention and adverse reaction procedures is vital. This study includes angiography, urography, transit studies, CT scans, and MRI as key contrast-enhanced exams. Employing a qualitative approach, it conducts a literature review. Neglecting risk assessment and safe administration can cause substantial disruptions due to adverse reactions. Protocols like desensitization and life support from a skilled medical team, alongside established protocols, reduce patient fatality risks.