Purpose To evaluate whether MR scanners with acoustic noise reduction and a short magnetic bore reduce the rate of claustrophobic reactions. Materials and Methods We performed a cohort study in an outpatient setting, enrolling a total of 55,734 consecutive patients referred for MRI of any part of the body based on a clinical indication. Imaging was performed using a conventional MR scanner (42,998 patients) and a recently developed MR scanner (12,736 patients) with 97% acoustic noise reduction and a short bore. Multiple logistic regression analysis was used to adjust for the nonrandomized design. Results In addition to those undergoing head‐first examinations, female and middle‐aged patients were significantly more likely to develop claustrophobia in the logistic regression analysis (P < 0.001). The rate of claustrophobic reactions was significantly lower with the recent MR scanner (0.7%; 95% confidence interval CI: 0.6–0.9%) than with the conventional scanner (2.1%; 95% CI, 2.0–2.3%; P < 0.001) with an adjusted odds ratio (OR) of 3.1 (95% CI, 2.5–3.9) and a number needed to treat of 72 (95% CI, 63–85). Conclusion The incidence of claustrophobia may be reduced by a factor of 3 when recently‐developed MR scanners are used. J. Magn. Reson. Imaging 2007;26:1322–1327. © 2007 Wiley‐Liss, Inc.