Heart failure (HF) is the leading cause of hospitalization in individuals over the age of 65. It is a clinical diagnosis where integration of cardiac imaging is pivotal to assessment and directly impacts management. Transthoracic echocardiogram (TTE) is the first line imaging diagnostic tool utilized in HF. Additional echocardiographic techniques, cardiac magnetic resonance imaging (CMR), cardiac computed tomography (CT), as well as various nuclear imaging modalities also have practical use in select patient populations with HF. Cardiac imaging has evolved with expanding technology as well as more widely available imaging tools, which have changed the landscape of HF diagnosis and management. This chapter will focus on the use of cardiovascular imaging in elderly HF patients.