Background: Magnetic resonance imaging (MRI) is a critical diagnostic modality, yet its availability in Sub-Saharan Africa remains disproportionately low. As countries like Cameroon gradually expand their diagnostic infrastructure often relying on refurbished equipment the implementation of stringent international MRI safety standards becomes increasingly complex. Objective: This narrative review evaluates the relevance of international MRI safety guidelines (e.g., ACR, IEC, ICNIRP) to the Cameroonian healthcare context, identifies specific implementation barriers, and proposes context-adapted strategies for resource-limited settings. Methods: Following the Scale for the Assessment of Narrative Review Articles (SANRA) criteria, a comprehensive literature search was conducted across PubMed/PMC, Scopus, and the grey literature of major regulatory bodies (WHO, ICNIRP, IEC, ACR) for publications predominantly between 2015 and 2025. The synthesis focused on safety standards, the health-system context in Cameroon, and the emergence of low-field MRI technologies. Findings: International standards are biophysically universally applicable but architecturally and economically misaligned with Cameroonian realities. Major implementation challenges include severe shortages of certified Medical Resonance Safety Officers (MRSOs) and medical physicists, inadequate facility space for strict four-zone layouts, reliance on refurbished scanners with outdated safety software, and unreliable power and helium supply chains. Local studies indicate significant gaps in general imaging referral guidelines among clinicians, translating to heightened risks in MRI environments. Conclusions: Direct transcription of high-income country MRI safety protocols to Cameroon is impractical. A staged, risk-based implementation strategy, integration of safety training into local medical physics curricula, and the adoption of ultra-low-field portable MRI systems offer viable pathways to improve diagnostic equity without compromising patient safety.