Cardiovascular MRI can assess multiple markers of myocardial viability in a single examination. Its accuracy is at least equivalent to, if not superior to, that of other currently available noninvasive imaging techniques, including positron emission tomography. The greater spatial resolution afforded by cardiovascular MRI, especially with the delayed-enhancement MRI (DE-MRI) technique, combined with the breadth and depth of correlative pathologic data, makes cardiovascular MRI a particularly powerful tool for detecting viable and irreversibly damaged myocardium. A wealth of clinical data exist, including data from multicenter efforts, to establish DE-MRI as a new gold standard in myocardial viability assessment. As the high accuracy and broad scope of DE-MRI are recognized, the technique will gain wider clinical use for analysis of dysfunctional myocardium and be integrated into the diagnostic and therapeutic algorithm.