In this review, the pathophysiology of anaphylaxis caused by contrast media and how to manage it from the viewpoint of medical safety are presented. Anaphylaxis is divided into allergic an-aphylaxis associated with IgE and IgG and non-allergic anaphylaxis not associated with them. Most cases of contrast media-induced anaphylaxis are considered non-allergic. When a contrast medium is injected into a blood vessel, changes in blood osmotic pressure, adhesion of the contrast media to IgE on mast cells, and activation of the intrinsic coagulation pathway and the complement system occur, which stimulate mast cells to degranulate histamine, etc. Ana-phylaxis is the ultimate hypersensitivity reaction that can rapidly lead to death. In the event of allergic or non-allergic anaphylaxis, adrenaline 0.3-0.5 mg should be administered immediately intramuscularly into the anterolateral thigh. National medical examination-level knowledge of immunology, pathology, and pharmacology is very helpful in understanding the above. Therefore, many past questions of medical national exams have been posted.

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