Chimeric antigen receptor (CAR)-T cell therapy, a novel approach involving the genetic modification of T cells to treat cancers, has recently attracted significant attention. This therapy has shown promising results in various cancers, particularly hematologic malignancies. However, it is not without challenges. CAR-T cell dysfunction, on/off tumor targeting, and antigen escape are among the key obstacles faced in the clinical application of this therapy. Furthermore, the therapy is associated with notable adverse effects, including cytokine release syndrome (CRS), CRS-related coagulopathy, and immune effector cell–associated neurotoxicity syndrome (ICANS). To address these challenges, researchers have explored various imaging techniques, such as optical imaging, magnetic resonance imaging (MRI), and radionuclide imaging. These imaging modalities have demonstrated potential in tracking the migration and localization of CAR-T cells, monitoring the therapeutic response and detecting adverse effects. Moreover, the integration of radiomics and artificial intelligence (AI) in CAR-T cell imaging has been investigated, showing promise in improving the accuracy of imaging modalities and revolutionizing CAR-T cell therapy. This chapter provides a comprehensive overview of the current findings along with insightful proposals for potential future research directions.