Cardiovascular magnetic resonance imaging (CMR) with delayed contrast enhancement (DCE) using Gadolinium based contrast media is a recently developed technique which allows the direct visualisation of myocardial necrosis or fibrosis as regions of bright signal (hyperenhancement) compared with normal myocardium. The manuscript presents a review of the current clinical application of DCE-CMR for the diagnosis and prognosis of various common cardiac conditions such as ischaemic and non-ischaemic cardiomyopathies, and less common diseases such as cardiac sarcoidosis or Löffler endocarditis (Table 1).