This chapter describes the utility of multimodality quantitative cardiothoracic imaging in cardio-oncology from a cardiology and lifespan perspective. Multimodality cardiothoracic imaging is essential throughout a patient’s oncological treatment and survivorship journey due to many cancer therapies’ known cardiotoxic effects, which potentially lead to heart failure, cardiomyopathy, coronary artery disease, and/or stroke. Multimodality imaging is used during cardiovascular risk assessment prior to cancer treatment, cardiotoxicity assessment during treatment, and surveillance for cardiotoxicity and atherosclerotic cardiovascular disease (ASCVD) post-treatment and among long-term survivors. The information included in this chapter provides radiologists and radiation oncologists context regarding what cardiac providers caring for these patients seek when they refer the patients for chest and cardiac imaging, whether before, during, or beyond cancer treatment.