In a patient with coronary artery disease, clinical, electrocardiographic, and angiographic information is often inadequate for determining the presence of viable tissue. The presence of wall thickening, even if reduced, indicates that the myocardium is viable. When wall thickening is absent, the myocardium may or may not be viable. The basis for the underlying myocardial dysfunction may be multifactorial in a single patient or even in a single myocardial segment. Cardiac imaging techniques are most useful in defining the mechanisms of underlying myocardial dysfunction and assist in selecting the optimal management strategy for patients. This review discusses the role of two-dimensional echocardiography and magnetic resonance imaging for the assessment of myocardial viability.