Recent advances in cardiovascular magnetic resonance have made it an important clinical tool. Late gadolinium enhancement imaging after gadolinium administration is now a well-validated and practical test to assess myocardial scarring. Due to its high spatial resolution, late gadolinium enhancement is much more sensitive in detecting small infarctions than older imaging modalities. However, late gadolinium enhancement is not specific for myocardial infarction but can occur in a number of cardiomyopathies. New studies suggest that the extent and pattern of enhancement may have prognostic and therapeutic implications, making it an important non-invasive instrument in cardiovascular diagnostics.