Cardiovascular CT and MRI are rapidly emerging technologies that can potentially change the current paradigm of cardiovascular imaging. Cardiac CT is primarily focused on imaging of coronary arteries for the assessment of vessel wall plaque and lumen stenosis. Additional information about ventricular and valvular function can also be obtained from the same three-dimensional image dataset. Cardiovascular magnetic resonance is a versatile imaging modality now considered a reference standard in the evaluation of ventricular morphology and function, with the potential to achieve a similar status in perfusion and viability assessment. This review summarizes key concepts regarding CT and MRI technology, clinical applications, and their role in clinical decision making. Recently published appropriateness criteria for cardiac CT and MRI by the American College of Cardiology are also reviewed.