Using image-based emails involves trade-offs between visual appeal, deliverability, and accessibility. While images can enhance engagement and provide a quick and easy design solution, relying solely on images can negatively impact deliverability due to spam filters and image blocking. Additionally, image-only emails create accessibility barriers for users with visual impairments if proper alt text is not provided. Email marketers recommend a balanced approach, combining images with sufficient text, optimizing images for size and responsiveness, and ensuring proper alt text for accessibility. Authentication protocols and user preferences can also influence how image-heavy emails are handled by ISPs.