Traditionally echocardiography has been the method of choice for the evaluation of pericardial and cardiac lesions. However, computed tomography (CT) and magnetic resonance imaging (MRI) provide a large field of view and excellent images of anatomy not available with echocardiography. In addition, CT and MRI demonstrate high soft-tissue contrast as well as the exact localization of a lesion. Currently, CT and MRI are the preferred techniques for the recognition and characterization of pericardial disorders. In this review, the characteristic imaging appearances of a variety of pericardial diseases are discussed.