Small vessel disease (SVD) refers to all pathological processes that affect the small vessels of the brain. SVD is an important cause of acute stroke, but is also a leading cause of aging-related cognitive decline and dementia, due to more insidious brain parenchymal damage. The introduction of high field strength MRI (7 T) is likely to offer important new perspectives on the role of SVD in these disorders. In this overview we illustrate the opportunities that 7 T MRI offers in high resolution vascular imaging. In particular, we will show the capability of 7 T MRI to depict the small arteries and veins in the brain, the vascular wall of intracranial arteries, perivascular spaces, and microvascular parenchymal lesions, including microbleeds and microinfarcts.