In 1984, Dixon published a first paper on a simple spectroscopic imaging technique for water and fat separation. The technique acquires two separate images with a modified spin echo pulse sequence. One is a conventional spin echo image with water and fat signals in-phase and the other is acquired with the readout gradient slightly shifted so that the water and fat signals are 180°out-of-phase. Dixon showed that from these two images, a water-only image and a fat-only image can be generated. The wateronly image by the Dixon's technique can serve the purpose of fat suppression, an important and widely used imaging option for clinical MRI. Additionally, the availability of both the water-only and fat-only images allows direct imagebased water and fat quantitation. These applications, as well as the potential that the technique can be made highly insensitive to magnetic field inhomogeneity, have generated substantial research interests and efforts from many investigators. As a result, significant improvement to the original technique has been made in the last 2 decades. The following article reviews the underlying physical principles and describes some major technical aspects in the development of these Dixon techniques. MR IMAGES ACQUIRED IN VIVO usually contain signals from both water and fat. In many pulse sequences, fat appears hyperintense. However, the contribution from water is often of the primary interest for many practical applications. Without suppression, the bright fat signal may result in aggravated motion-related artifacts and, more importantly, reduce the underlying lesion conspicuity. Because of its chemical shift, fat is also responsible for the well-known spatial misregistration artifacts, which can appear both along the frequency encode direction and along the slice select direction. For a few other applications such as diagnosis of bone marrow diseases or hepatic steatosis, detection rather than suppression of the fat signal can also be valuable.Several approaches have been proposed and developed for achieving fat suppression. Perhaps the most popular is the chemical shift selective saturation (1) or its variants. In this approach, a frequency selective radiofrequency (RF) pulse and a spoiler gradient pulse are used in conjunction to first excite and then saturate the fat magnetization before water is excited for imaging. Alternatively, a frequency selective RF pulse can be used to directly excite only the water magnetization and leave the fat magnetization alone along the longitudinal axis. These techniques, particularly the selective saturation technique, are easy to implement and have been widely used with great success. However, both selective saturation pulses and selective excitation pulses increase the scan time. Another limitation for fat suppression by the selective saturation pulses is that it typically requires an accurate 90°flip angle, and as a result, its performance can be dependent on B1 homogeneity. Perhaps most importantly, fat suppression using the frequency selective approach...