The use of interventional therapy in acute myocardial infarction has intensified the desire to obtain accurate information on regional myocardial perfusion. MR imaging using ultrafast techniques and contrast agents may be useful to estimate myocardial perfusion in patients with coronary artery disease. In addition, MR imaging with contrast agents is capable of defining the infarcted region and the area at risk after coronary artery occlusion. Quantitative evaluation of regional myocardial contractile function with and without pharmacologic stress testing further improves the utility of MR imaging in defining the effects of reperfusion therapy on dysfunctional myocardium and in detecting myocardial ischemia. Furthermore, cine MR techniques are now used extensively to assess cardiac function and volumes and to obtain flow velocity maps. Cardiac MR applications are evolving rapidly and the clinical significance is expanding.