Macroscopic visualization of functional and molecular features of cardiovascular disease is emerging as an important tool in basic research and clinical translation of new diagnostic and therapeutic strategies. We showcase the application of Multispectral Optoacoustic Tomography (MSOT) techniques to noninvasively image different aspects of the mouse cardiovascular system macroscopically in real-time and in vivo, an unprecedented ability compared to optical or optoacoustic (photoacoustic) imaging approaches documented so far. In particular, we demonstrate imaging of the carotid arteries, the aorta and the cardiac wall. We further demonstrate the ability to dynamically visualize circulating gold nanorods that can be used to enhance contrast and be extended to molecular imaging applications. We discuss the potential of this imaging ability in cardiovascular disease (CVD) research and clinical applications.