Coronary artery disease is one of the leading causes of morbidity and mortality in the elderly population. Currently, the work up of coronary artery disease requires an integrated approach utilizing several diagnostic imaging modalities including coronary x-ray angiography, echocardiography, and radionuclide scintigraphy. Magnetic resonance imaging (MRI) for cardiac imaging offers great potential in the work up of ischemic heart disease. MRI allows the evaluation of the coronary arteries, quantitation of coronary flow and flow reserve, and determination of viability of ischemic myocardium. This paper reviews established and future applications of cardiac MRI with special emphasis on ischemic heart disease. (c)1999 by CVRR, Inc.