Although the majority of incisional hernias can be diagnosed after obtaining a detailed history and physical exam, obtaining preoperative imaging can confirm the diagnosis, identify occult hernias, and assist in operative planning. For the modern abdominal wall surgeon, cross-sectional imaging has become the cornerstone of preoperative planning. In this chapter, we will discuss the importance of obtaining routine imaging preoperatively for incisional hernia repair, selection of the appropriate imaging modality, a process for systematically interpreting the images, and briefly review hernia radiomics that may influence the choice and timing of an operative intervention.