Spin-echo imaging is commonly used for assessment of cardiac and great vessel anatomy. With classic spin-echo imaging, rapidly moving blood appears dark. At current field strengths (1.5 and 3.0 tesla), cardiovascular magnetic resonance (CMR) imaging is considered safe for bioprosthetic and mechanical heart valves. Older (pre-2000) cardiac pacemakers and implantable defibrillators are an absolute contraindication to higher field (≥0.5 T) CMR. Patients with newer pacemaker systems may be safely scanned using specific protocols. Cardiovascular magnetic resonance is an important noninvasive technique for evaluating thoracic aortic aneurysms. The clinical “gold standard” for the diagnosis of pulmonary embolism is contrast CT angiography (CTA). For patients who are not candidates for CTA due to renal dysfunction or contrast allergic history, pulmonary artery magnetic resonance angiography (MRA) is an excellent noninvasive alternative with high sensitivity and specificity. Cine CMR provides an excellent means for quantitative assessment of left and right ventricular volumes, global ejection fraction, regional systolic function, and biventricular mass. Available data suggest dobutamine stress CMR is a sensitive technique for the noninvasive recognition of coronary artery disease (CAD). Coronary artery bypass graft patency is well evaluated by spin echo, gradient echo, and gadolinium-diethylenetriamine pentaacetic acid (DTPA)-enhanced three-dimensional (3D) enhanced coronary magnetic resonance imaging (MRI). Cardiovascular magnetic resonance provides the noninvasive means to assess myocardial viability and fibrosis accurately. Cardiovascular magnetic resonance has great value for characterizing paracardiac and extracardiac tumors and their extension into the myocardium, cardiac chambers, or neighboring mediastinal structures. Both spin-echo CMR and CT are capable of measuring pericardial thickness accurately. Cardiovascular magnetic resonance has great utility for both simple and complex congenital heart disease. Coronary MRI for identification and characterization of anomalous coronary arteries is widely accepted.