Prostate MRI and image Quality: It is time to take stock

•Endorectal coil increases SNR for T2WI and DWI MRI, but it results in more motion and susceptibility artifacts. It has no clear impact on subjective image quality, prostate cancer detection.•Hyoscine butylbromide (scopolamine butylbromide) reduces rectal motion and improves T2WI quality.•Rectal enema alone or in conjunction to dietary restrictions is superior to hyoscine butylbromide alone in improving MRI quality.•Deep learning-based reconstruction can improve SNR, CNR, and subjective image quality of prostate MRI while shortening image acquisition time. Multiparametric magnetic resonance imaging (mpMRI) plays a vital role in prostate cancer diagnosis and management. With the increase in use of mpMRI, obtaining the best possible quality images has become a priority. The Prostate Imaging Reporting and Data System (PI-RADS) was introduced to standardize and optimize patient preparation, scanning techniques, and interpretation. However, the quality of the MRI sequences depends not only on the hardware/software and scanning parameters, but also on patient-related factors. Common patient-related factors include bowel peristalsis, rectal distension, and patient motion. There is currently no consensus regarding the best approaches to address these issues and improve the quality of mpMRI. New evidence has been accrued since the release of PI-RADS, and this review aims to explore the key strategies which aim to improve prostate MRI quality, such as imaging techniques, patient preparation methods, the new Prostate Imaging Quality (PI-QUAL) criteria, and artificial intelligence on prostate MRI quality.