Atherosclerosis is the disease that causes heart attack and stroke. Although driven by excess cholesterol, atherosclerosis is a chronic inflammatory disease. Macrophages engage inflammatory pathways such as the inflammasome and activate NFkappa B transcriptional of cytokines to propagate inflammation, and new clinical data suggests that targeting these pathways therapeutically holds promise for patients with CVD. We will discuss new advances in inflammatory pathways in the advanced atherosclerotic plaque and how they may be leveraged for imaging of advanced atherosclerosis.