Congenital and acquired valvular disease remains a frequent cause of morbidity and mortality. It presents a diagnostic challenge in all age groups, and often occurs in conjunction with other types of heart disease. Traditional chest radiography provides the earliest opportunity for radiologic diagnosis, hence the need for skill and knowledge in interpreting the radiographic findings. Echocardiography with color flow Doppler measurements is frequently the next modality applied. CT and MR imaging can simultaneously display cardiovascular morphology with greater spatial resolution than ultrasound, and at the same time provide quantitative assessment of cardiac function. The role of diagnostic imaging is therefore crucial, both for primary diagnosis and in the management of valvular heart disease. Furthermore, it is fundamental in evaluating the results of all forms of interventional therapy.