Deep inferior epigastric perforator (DIEP) flaps have become the state of the art in autologous breast reconstruction. Identification of deep inferior epigastric perforators (DIEP) is important for DIEP flap planning. CT angiogram (CTA) is gold standard for this purpose. However, CTA is associated with ionizing radiation. An objective, evidencebased systematic review of the literatures was carried out to find out the accuracy of MR angiogram in the DIEP flap planning. Despite CTA is an acceptable gold standard, the present systematic review demonstrated that the current improved MRA imaging protocol could be used efficiently for DIEP flap planning and could be as comparable as CTA imaging for this purpose.