Atherosclerosis represents the leading cause of mortality and morbidity in the world. Two of the most common, severe, diseases that may occur, acute myocardial infarction and stroke, have their pathogenesis in the atherosclerosis that may affect the coronary arteries as well as the carotid/intra-cranial vessels. Therefore, in the past there was an extensive research in identifying pre-clinical atherosclerotic diseases in order to plan the correct therapeutical approach before the pathological events occur. In the last 20 years imaging techniques and in particular Computed Tomography and Magnetic Resonance had a tremendous improvement in their potential. In the field of the Computed Tomography the introduction of the multi-detector-row technology and more recently the use of dual energy and multi-spectral imaging provides an exquisite level of anatomic detail. The MR thanks to the use of strength magnetic field and extremely advanced sequences can image human vessels very quickly while offering an outstanding contrast resolution.