Cardiovascular magnetic resonance (CMR) imaging plays a major role in the diagnosis and assessment of coronary artery disease (CAD). This chapter will focus on the diagnosis of ischaemia by CMR with brief reference to viability assessment, which is covered in detail elsewhere. Perfusion-CMR has matured to a reliable technique for the assessment of CAD. It detects and excludes CAD with a high diagnostic performance. There is also increasing evidence from single-centre studies and the European CMR registry for the high prognostic value of ischaemia detection by perfusion-CMR and a normal CMR study in patients with or without known CAD predicts a rate for MACE of 0.3–1%/year. Coronary angiography by CMR will not be discussed in this chapter, however, as it is only recommended for delineation of the course of coronary artery anomalies.