Cardiovascular magnetic resonance imaging (MRI) demonstrates location, activity and extent of inflammation in acute myocarditis. A combined approach, using different imaging modalities (T2-IR-weighted imaging, early and late gadolinium enhancement) provides high diagnostic accuracy. The type of myocardial virus infection (PVB19, HHV6) may be related to the pattern of inflammation demonstrated by cardiovascular MRI and the clinical course. Whether specific patterns of late gadolinium enhancement in myocarditis are associated with poor prognosis remains a subject for further investigation. Cardiovascular MRI in myocarditis is believed to become a significant imaging tool in identifying patients at risk for heart failure and ventricular arrhythmias. These patients may need specific treatment, such as antiviral or immunosuppressive medication, dependent on the result of endomyocardial biopsy.