Noninvasive, high-resolution MRI has shown its efficacy in the visualization of carotid atherosclerotic plaque characteristics. MRI is the only noninvasive option for thin plaque cap, active inflammation, fissured/injured plaque and intraplaque hemorrhage, is also useful in monitoring the response after statin therapy, and has the potential to image a coronary plaque and to determine its composition. New contrast agents and targeted molecular imaging open a window for MRI detection of thrombi and assessment of atherosclerotic activity and plaque vulnerability. Currently, multidetector CT is capable of the noninvasive detection of coronary stenosis and coronary calcifications. High resolution CT may be beneficial in the detection of noncalcified vulnerable coronary plaques, and more reliable with the use of newer high-speed volume CT scanners.