Lowering levels of low-density lipoprotein cholesterol with inhibitors of 3-hydroxy-methylglutaryl coenzyme A reductase (statins) has a profound impact on cardiovascular event rates. The degree of benefit is proportional to the extent of low-density lipoprotein cholesterol lowering achieved. In addition to lowering levels of atherogenic lipids, statins have been reported to possess nonlipid-modifying properties that may contribute to their clinical benefit. It remains to be determined to what extent these properties modify atherosclerotic plaque in humans. A number of imaging modalities provide a unique opportunity to monitor the effect of medical therapies on the extent and composition of atherosclerotic plaque. The use of these imaging modalities highlights the impact that statins have on atherosclerosis as a possible rationale for their clinical benefit.