Off resonance RF irradiation can induce the ordering of proton spins in the dipolar fields of their neighbors, in molecules with restricted mobility. This dipolar order decays with a characteristic relaxation time, T 1D , that is very different from the T1 and T2 relaxation of the nuclear alignment with the main magnetic field. Inhomogeneous Magnetization Transfer (ihMT) imaging is a refinement of Magnetization Transfer (MT) imaging that isolates the MT signal dependence on dipolar order relaxation times within motion constrained molecules. Since T 1D relaxation is a unique contrast mechanism, ihMT may enable improved characterization of tissue. Initial work has stressed the high correlation between ihMT signal and myelin density. Dipolar order relaxation appears to be much longer in membrane lipids than other molecules. Recent work has shown, however, that ihMT acquisitions may also be adjusted to emphasize different ranges of T 1D . These newer approaches may be sensitive to other microstructural components of tissue. Here we review the concepts and history of ihMT and lay out needs for further development to realize its full potential.Inhomogeneous magnetization transfer imaging(1), or ihMT, is a refinement of magnetization transfer that provides different contrast between tissues than MT by isolating dipolar order effects within motion restricted molecules(2) that are weighted by the corresponding dipolar relaxation time, T 1D .Because dipolar order relaxation is slower in myelinated tissues than any other tissue observed, it is highly sensitive to myelin. More broadly, the addition of a new relaxation mechanism for MRI that reflects macromolecular structure and mobility and with clearly different properties from T 1 and T 2 opens the possibility of heightened sensitivity to pathology.Though a growing body of literature describes the properties of ihMT MRI, much work remains to realize its potential for research and clinical studies. After a brief introduction, this review is organized around 6 major directions for further investigation and development: 1. Determining the underlying physics and tissue parameters behind ihMT; 2. Estimating, validating, separating, and interpreting different T 1D components; 3. Optimizing acquisition methods; 4. Optimizing quantification methods; 5.