Cardiac MR imaging to date has provided detailed information regarding cardiac structure and anatomy. Recent developments in imaging speed have broadened the applications of cardiac MR from the research laboratory to a wide variety of clinical applications involving assessment of both cardiac function and perfusion. In this review, we present methods used for MR evaluation of acquired cardiac disease in the adult. Applications to ischemic heart disease, cardiomyopathy, coronary imaging, myocardial perfusion, and pericardial disease are discussed.