Delirium is an acute change of consciousness and cognition that is associated with poor outcome. The arsenal to treat delirium is limited due to the poor understanding of the pathophysiology of the underlying encephalopathy. Neuroimaging can be used to elucidate possible neural mechanisms. In delirium, however, neuroimaging is still in its infancy. Despite concerns about the feasibility of neuroimaging in delirious patients, several investigations have been performed. Most structural imaging studies suggest that delirium is associated with more brain atrophy and focal abnormalities, such as infarcts and white matter disruption. Functional imaging studies suggest perfusion abnormalities and altered functional connectivity. More advanced imaging techniques may provide new insight in the pathophysiology of delirium.