Purpose of Review <p>Photoacoustic tomography (PAT) has emerged as a promising non-ionizing imaging modality that leverages optical absorption contrast to provide anatomical, functional, and metabolic insights. This review highlights recent advancements in PAT for assessing hemodynamics and metabolic function in the diagnosis, treatment, and monitoring of cardiovascular diseases (CVDs).</p> Recent Findings <p>PAT has been applied to evaluate vascular morphology, blood flow, perfusion, and cardiac hemodynamics. It has also been used for metabolic assessments, including oxygenation, lipid accumulation, glucose dynamics, collagen distribution, and inflammatory responses.</p> Summary <p>By selecting appropriate wavelengths, PAT can target specific molecular contrasts, while multi-wavelength imaging enables simultaneous visualization of multiple biomarkers. These capabilities provide a comprehensive view of CVD progression and treatment. Ongoing technological advancements, clinical trials, and translational efforts are essential for validating PAT’s clinical utility and accelerating its integration into routine cardiovascular care.</p>