Ductal carcinoma in situ (DCIS) is a preinvasive malignancy and a nonobligate precursor to invasive carcinoma. DCIS shares common risk factors with invasive carcinoma in terms of age, hormonal influence, and genetic factors; hence it is thought to be a precursor to invasive carcinoma. There is proliferation of malignant cells within the terminal ductal lobular unit and can spread into the lactiferous ducts or involve the nipple without invasion of the basement membrane or myoepithelial layer. It is crucial to detect malignancy in this early stage for providing optimal patient management. DCIS rarely presents as a palpable mass and thus mostly detected in asymptomatic women on screening mammography. The commonest presentation is with fine pleomorphic calcification, which is best detected by mammography. The noncalcified DCIS can be better delineated on contrast-enhanced magnetic resonance imaging. Mammography along with ultrasonography are the imaging modalities used for detection followed by tissue sampling. Contrast-enhanced spectral mammography has added a new dimension to the delineation of extent of the disease by demonstrating the enhancing component along with the visualization of microcalcification. Magnetic resonance imaging stays as the gold standard by virtue of its better resolution and illustration as nonmass enhancement for DCIS. This chapter provides a comprehensive review of the various imaging modalities available for diagnosis, pathological evaluation, and management of DCIS.