Imaging the knee prior to and following total knee arthroplasty (TKA) play a crucial role in the indication for surgery, surgical planning and post-operative management. While there are several modalities to image and evaluate the knee, each has its own merits. Preoperative radiographs provide the overall impression of the knee demonstrating the degree of arthritis, alignment, and deformity. The utility may also be integrated into surgical planning with a personalized approach to the correction of the deformity and implant selection. The postoperative radiographs are valuable in routine surveillance, assessing the ultimate outcome and diagnosing complications such as loosening, wear, instability and infection. Computerized tomography (CT) scans provide a 3-D assessment of the knee and have been helpful in the preoperative planning for component size and position, as well as the postoperative evaluation of component position and rotation. Data collected from CT based surgical plans have been used in creating the virtual bone models in robotic surgery. The CT scan has also been helpful following surgery, in diagnosing osteolysis or loosening that is not evident on standard radiographs. Magnetic resonance imaging (MRI) provides a great deal of information about the bone and surrounding soft tissue and when coupled with specific software has been used for establishing the preoperative plan in robotic surgery. Fluroscopy allows for the assessment of real-time joint motion and evaluation of the knee kinematics. It allows observation of the movement of femoral and tibial components following TKA. With the introduction of advanced technology with a personalized approach to TKA, we have seen the increased use of advanced imaging to provide a 3-D modeling of the knee that is incorporated into the surgical planning.