Assessment of the intracranial flow is important for the understanding and management of cerebral vascular diseases. From brain aneurysms and arteriovenous malformations lesions to intracranial and cervical stenosis, the appraisal of the blood flow can be crucial and influence positively on patients' management. The determination of the intracranial hemodynamics and the collateral pattern seems to play to a major role in the management of these lesions. 4D flow magnetic resonance imaging is a noninvasive phase contrast derived method that has been developed and applied in neurovascular diseases. It has a great potential if followed by further technical improvements and comprehensive and systematic clinical studies.