Cardiac magnetic resonance imaging (MRI) has been established in a large variety of cardiac diseases including congenital heart disease (CHD), ischemic heart disease, valvular heart disease and a wide selection of primary diseases of the myocardium (cardiomyopathies). The impact of CMR also reaches beyond the heart itself and includes downstream vasculature. Based of continuous discoveries in genetics and genomics with identification of causal genes the perception, diagnosis and management may potentially change. Genetic diseases in general refer to disease caused by abnormalities in the genome which are generally present from birth. Furthermore, it is important to consider that genetic diseases may or may not be of heritable nature, a factor that is of high importance regarding the risk of future generations as well as considerations of counseling and screening of family member. An important consideration is the differentiation between ‘genotype’ and ‘phenotype’. Genotype refers to an individuals’ collection of genes which may or may not include an abnormality while phenotype refers to the ‘observable’ findings which, in respect to cardiac MR, mainly apply to the characterization of morphologic and potentially also quantitative tissue composition. As a major and versatile diagnostic tool in cardiovascular disease, cardiac MRI may be challenged regarding differential diagnosis of look alike phenocopies but may also push its role as a screening modality in cases with positive family history and/or positive genotype to assess for phenotype expression. Furthermore, cardiac MRI remains a major tool in therapy decisions and therapy monitoring in a wide range of genetic cardiovascular pathologies.Cardiomyopathies, defined as primary diseases of the heart muscle excluding those that are secondary to other known CV disorders (e.g. coronary artery disease, hypertension, etc.) have undergone various changes in classifications and most recent society classifications have further highlighted the differentiation of familial/genetic forms from nonfamilial/nongenetic forms and also consider asymptomatic individuals with familial cardiomyopathy in heart failure (HF) classifications (1,2). While from certain perspectives results may appear relatively straight forward, the complexity may be a substantial challenge for clinicians (3). A major aspect of cardiac MRI in assessment of genetic myocardial disorders remains the assessment of general phenotypes (e.g. hypertrophic, dilated, etc.), the assessment of cardiac function and assessment of myocardial changes. Beyond standard assessment of global cardiac function and volumes, regional wall motion metrics provided by various techniques to assess for strain and derivatives potential allows for early/pre-symptomatic identification of abnormalities. Recent developments in detailed quantitative myocardial imaging allow for identification of subtle myocardial changes that may come along with various genetic diseases prior to phenotype changes or functional impairment. However, only in very few disorders quantitative data may allow for diagnosis of specific disease (e.g. Fabry’s) (4).Cardiac MRI has proven its role in the diagnosis of various pathologies of the central vasculature. This includes genetically linked disorders such as Marfan’s syndrome, Ehlers-Dahnlos syndrome, Loeys-Dietz syndrome and other familial aortopathies. While it may be common conception that the focus of MR based investigations may only relate to vascular structures, various syndromes may also include risk of valvular disease and heart failure therefore requiring adequate imaging methods. In primary diagnosis cardiovascular imaging only provides more detailed insight into a multiorgan-system/tissue disease and as such normal findings may not necessarily exclude such a diagnosis. The primary role of cardiac MRI at present times focuses on initial diagnosis of complications (e.g. aneurysms, dissections) as well as pre-/post-interventional surveillance. Primary MR tools include functional imaging techniques for assessment of ventricular function and valvular pathologies such as insufficiency, and non-contrast or contrast enhanced 2D/3D MR angiography techniques for mapping of the vascular morphology and measurements. Furthermore, flow imaging techniques may provide further insight into imaging of complications and additional information about vascular rigidity.The field of genetic disorders in cardiovascular imaging by MRI includes a wide variety of general approaches from basic diagnosis (incl. differential diagnosis), non-invasive therapy monitoring, screening for complications as well as screening of dependents in the setting of potential inheritable disease. Especially the later application may require identification of subtle structural changes and morphological variants that possibly provide further hints. In the emerging field of cardiomyopathy classification, the connection between ‘genotype’ and ‘phenotype’ may proof of high importance as despite the presence of proven gene abnormalities (genotype +) the penetration of disease may vary and individuals may remain ‘phenotype -‘ for extended periods or the remainder of their life.