Animal models facilitate our understanding of human disease by providing a controlled environment permitting testing of mechanisms of disease, diagnostic technologies and therapeutic interventions. The ideal animal model should display coronary lesions resembling those seen in human atherosclerosis. No suitable large animal model of high-risk (vulnerable) plaque exists. Lack of such a model has hampered studies designed to validate imaging technologies and to scrutinise the effects of therapeutic interventions in atherosclerotic arteries. Several porcine models of advanced human-like coronary atherosclerosis exist. In this review some of the most promising porcine models are discussed, focusing on their applicability in the development and validation of coronary imaging technologies and interventional devices. In the evolving era of technological development, the availability and use of such animal models of advanced human-like coronary atherosclerosis and vulnerable plaque will become critically important in the preclinical testing of emerging technologies in interventional cardiology.