Atherosclerosis is the underlying cause of most cardiovascular-related deaths in industrialized nations. Determining the etiology of atherosclerosis and detecting lesions in the early stages of the disease for possible pharmacological or mechanical intervention have been challenges facing cardiovascular researchers. In addition to genetic and environmental factors, the formation and growth of atheroma have been linked to the complex fluid dynamics and mass transport in these arterial segments. This article reviews the current state of affairs in imaging modalities and image processing techniques that allow the visualization and morphologically realistic reconstruction of coronary arterial geometry to aid in the diagnosis and treatment of coronary artery disease (CAD). In addition, studies pertaining to our current understanding of the complex flow dynamics in the coronary arteries and the relationship between fluid-induced stresses on the initiation and growth of the atherosclerotic lesions are also reviewed. The article concludes with a brief discussion on possible future directions of research that will advance our knowledge of this challenging problem.