Chronic heart failure is a common disorder associated with high mortality and morbidity. Patients' numbers and the burden placed on health care services increase as the average age of the population rises. Non-invasive imaging plays a central role in the correct diagnosis of heart failure, the determination of aetiology and prognosis, as well as the monitoring of ongoing therapy. In this review paper we critically summarize techniques that differentiate ischaemic from non-ischaemic cardiomyopathy. Coronary angiography has been used as the primary method for distinguishing ischaemic from non-ischaemic cardiomyopathy; while studies utilizing echocardiography, myocardial perfusion imaging or electron computed tomography and positron emission tomography, have played a substantial role. More recently, CMR and multislice computed tomography have demonstrated ability in initial functional assessment and in the determination of secondary causes of heart failure.