Brain imaging is one of the important diagnostic tool to elucidate cerebrovascular diseases. The common clinical routine is based on the technique of brain imaging by computed tomography (CT) or magnetic resonance (MR) and the imaging of the arterial vessels by means of ultrasound, CT angiography (CTA), or magnetic resonance angiography (MRA). Important information is obtained about type and pattern of brain lesions, perfusion of the brain, status of the vessels as well as the vessel wall. All tools are complementary and redundant techniques having advantages and disadvantages. The need for the gold standard - selective intraarterial angiography - is more and more limited to therapeutic interventions like angioplasty or local thrombolysis. MRI spectroscopy as well as diffusion tensor imaging provide new perspectives in the diagnosis of atherosclerotic brain lesions.