The administration of iodinated contrast media (ICM) is indispensable for modern diagnostic and interventional procedures. However, the subsequent development of acute kidney injury (AKI) represents a significant clinical challenge, associated with increased morbidity, mortality, and healthcare expenditure. Historically termed contrast-induced nephropathy (CIN), the understanding of this condition has evolved, leading to the more precise term contrast-associated AKI (CA-AKI) to reflect a temporal association rather than assumed causality. The pathophysiology is multifactorial, involving direct tubular cytotoxicity, renal vasoconstriction leading to medullary hypoxia, and oxidative stress. While the risk is low in the general population, it is markedly elevated in patients with pre-existing chronic kidney disease (CKD), diabetes mellitus, heart failure, and in the context of intra-arterial procedures with high contrast volumes. The prevention of CA-AKI has traditionally been managed in departmental silos, an approach that is often fragmented and unreliable. This review proposes a comprehensive, multidisciplinary framework that integrates the expertise of four key pillars: Radiology, Pharmacy, Anesthesia, and Public Health. Effective prevention begins with a shared foundation of robust risk stratification, leveraging quantitative scoring systems and automated electronic health record (EHR) alerts. The Pharmacy pillar focuses on evidence-based pharmacological and medication management, including standardized hydration protocols, controversial adjunctive therapies like N-acetylcysteine and statins, and a critical "nephrotoxic hold" on high-risk medications. The Radiology pillar centers on procedural optimization through the selection of appropriate contrast agents, strict adherence to the principle of dose minimization guided by dose-to-eGFR ratios, and the use of advanced technologies like automated injectors and ultra-low contrast techniques. The Anesthesia pillar provides intraprocedural hemodynamic stewardship for high-risk patients, maintaining renal perfusion through goal-directed fluid therapy and judicious use of vasopressors. Finally, the Public Health pillar provides the system-level architecture for success, designing and implementing hospital-wide "prevention bundles," fostering interdepartmental communication, promoting patient education, and driving continuous quality improvement through audit and feedback. By synergizing these distinct but complementary roles, healthcare systems can transition from a reactive to a proactive and reliable model of care, significantly reducing the clinical and economic burden of CA-AKI.