The main goal of this literature review is to discuss the emerging trends, challenges and opportunities in the field of medical imaging education in Europe due to the Covid-19 pandemic scenario that forced the remodeling of the teaching and learning process. A bibliographic search was carried out in the main databases and from resources available in scientific and professional associations in Europe. Exclusion criteria included articles without contributions on distance learning or active learning. Education and training in medical imaging field had to readapt and the usual opportunities for medical imaging and radiotherapy (MIR) students to learn in person in the classroom, lab and clinical settings, had to be quickly transformed into distance learning opportunities. Thus, online education became a pedagogical shift from traditional method to the modern approach of teaching and learning from classroom to Zoom, from personal to virtual and from seminars to webinars, leading to the emergence of innovative teaching models. Moreover, student-centered strategies such as flipped classroom and game-based learning have been recently applied in health professions education with positive and very promising results. In conclusion, due to the pandemic crisis, MIR educators and students find themselves in the situation where they felt compelled to embrace the digital academic experience, allowing the progressive innovation of e-learning. In this context, game-based learning appears to be effective for improving knowledge, skills, attitudes and satisfaction and should be considered as a potential systematic tool in the field of medical imaging education. Therefore, preparedness of radiographers depends on the application of effective training and education methodologies that allows excellent clinical performance and maintaining high quality and safety standards, both through undergraduate course and continuous professional development.