Motivation: Moyamoya disease necessitates precise visualization of cerebral vessels for management, but current imaging may be inadequate. Goal(s): To ascertain if 5.0-T 4D NCEMRA offers superior imaging of collateral circulation in Moyamoya disease compared to traditional TOF MRA. Approach: Utilized 5.0-T MRI to compare 4D NCEMRA and TOF MRA in visualizing leptomeningeal collateral anastomoses in 19 patients. Results: 5.0-T 4D NCEMRA outperformed TOF MRA, particularly in identifying leptomeningeal collaterals, with significant statistical support. Impact: The study underscores 5.0-T 4D NCEMRA's potential to enhance cerebral vascular mapping in Moyamoya disease, prompting advancements in diagnostic and therapeutic strategies, possibly leading to more personalized patient care.