Molecular imaging is concerned with the presentation, description and quantification of biological and physiological processes at the cellular and molecular level. Most recently molecular imaging has started to become established in breast diagnostics. This review article will give an overview of procedures which are either in the preclinical development stage or which have already become clinically established. Molecular nuclear medicine breast imaging (breast-specific gamma imaging [BSGI] and positron emission mammography [PEM]) together with specific radiotracers and contrast media will be discussed. The possibilities for magnetic resonance imaging in functional (DWI) and metabolic (MRSI) imaging of breast lesions and the combined application of nuclear medicine and magnetic resonance imaging (PET/MRI) will be explained. Furthermore, an overview on the preclinical procedure and the possible clinical applications of optical and photoacoustic imaging will be given.