This review discusses the risk factors for developing amyloid-related imaging abnormalities (ARIA) and their clinical implications in patients with Alzheimer's disease (AD) treated with anti-amyloid monoclonal antibodies. ARIA is classified into two types: ARIA-E (edema) and ARIA-H (hemorrhage), both of which can occur following treatment with these therapies. ARIA-E is associated with brain edema and is more common in patients with the ApoE ε4 allele and a history of cerebral microhemorrhages. ARIA-H is linked to age, antithrombotic use, and a history of strokes. The incidence of ARIA varies among different anti-amyloid therapies, with lecanemab showing lower rates of ARIA-E and ARIA-H compared to aducanumab. Risk factors for ARIA have influenced inclusion and exclusion criteria for these therapies, leading to a significant portion of Alzheimer's patients being excluded from treatment. The review highlights the importance of considering patient risk factors before initiating anti-amyloid therapy to minimize the risk of ARIA. It also emphasizes the need for further research into the long-term effects and other potential risk factors, including race, sex, and vascular changes, in the context of anti-amyloid therapy.This review discusses the risk factors for developing amyloid-related imaging abnormalities (ARIA) and their clinical implications in patients with Alzheimer's disease (AD) treated with anti-amyloid monoclonal antibodies. ARIA is classified into two types: ARIA-E (edema) and ARIA-H (hemorrhage), both of which can occur following treatment with these therapies. ARIA-E is associated with brain edema and is more common in patients with the ApoE ε4 allele and a history of cerebral microhemorrhages. ARIA-H is linked to age, antithrombotic use, and a history of strokes. The incidence of ARIA varies among different anti-amyloid therapies, with lecanemab showing lower rates of ARIA-E and ARIA-H compared to aducanumab. Risk factors for ARIA have influenced inclusion and exclusion criteria for these therapies, leading to a significant portion of Alzheimer's patients being excluded from treatment. The review highlights the importance of considering patient risk factors before initiating anti-amyloid therapy to minimize the risk of ARIA. It also emphasizes the need for further research into the long-term effects and other potential risk factors, including race, sex, and vascular changes, in the context of anti-amyloid therapy.