Investigate whether radiology residents make correct diagnosis of contrast media reactions and evaluate their treatment of reaction using simulation technology. Residents were presented with a test scenario of patient given IV contrast having anaphylactic reaction. A computer-run mechanical mannequin that simulates, with mathematical, pharmacokinetic, pharmacodynamic and cardiovascular algorithms, was used. Sessions were evaluated with respect to whether residents performed key actions to treat anaphylaxis. Times were recorded. All residents recognized the contrast reaction and initiated basic actions. As the scenario progressed and patient deteriorated, all recognized need to intubate, but intubation performance varied significantly. Radiology residents generally not prepared to deal with IV contrast reactions. Simulation technology to practice key actions would improve their preparedness.