T he ability of magnetic resonance imaging (MRI) to evaluate cardiovascular pathophysiology at several levels is one of the strengths of the technique. As shown in Figure 1, cardiac phenotype can be assessed at the wholeorgan level by cine MRI, at the regional level with strain, perfusion, and viability imaging, and at the metabolic level with spectroscopic techniques. 1,2 However, MRI of biological processes at the cellular and subcellular level (molecular MRI) has been studied most extensively in other disease states such as cancer. 3,4 Molecular MRI techniques are, however, being increasingly developed for cardiovascular applications and, if fully developed, have the potential to make a significant impact on the practice of cardiovascular medicine.The advantages of an MRI-based approach to molecular imaging reflect the general attributes of the technique. MRI is noninvasive, tomographic, nonionizing, and able to generate images with high spatial resolution and excellent soft tissue contrast. In the initial portion of the present review, the technology that underlies molecular MRI agents is reviewed. The application of these agents to the imaging of myocardial disease, atherosclerosis, and stem cell therapy in the heart is then discussed. Finally, the potential of multispectral and hybrid imaging techniques is explored.