Magnetic resonance imaging (MRI) can provide a non-invasive combined diagnostic examination of different modalities including visualisation of vascular and cardiac anatomy and measurements of blood flow and left ventricular mass, function, perfusion and viability. Contrast agents for cardiovascular imaging are used to enhance the capability of MRI in assessing perfusion, tissue viability, infarction and vascular stenosis. Furthermore, contrast agents may be used for guiding procedures and therapies in the evolving field of interventional MRI such as angioplasty and delivery of genes and growth factors. Targeted MR contrast agents are needed to further improve the specificity of MRI and to monitor pathophysiological processes including necrosis, inflammation or angiogenesis. The research and development of MR contrast agents will continue at the cellular and molecular levels in the next decade.