Contrast-enhanced mammography (CEM), also known as contrast-enhanced spectral mammography, has emerged as a new technique as an alternative to overcome the shortcomings of other readily available modalities. It involves rapid successive acquisition of two images of the breast with X-rays of two different energies after contrast administration. CEM demonstrates the pathologies similar to FFDM and utilizes iodinated contrast agents for illustration of lesion enhancement. It therefore carries a dual advantage of showing the anatomic as well as perfusion related changes which are attributed to the tumour angiogenesis. The utility of CEM has been investigated for several indications since its introduction almost a decade back. This chapter aims to introduce this new modality, describe its principle and discuss its potential clinical indications.