During normal pregnancy, the maternal cardiovascular system undergoes significant hemodynamic changes to accommodate the growth and delivery of the child. The presence of cardiovascular disease in the pregnant patient has increased due to the increased maternal age and the increased longevity of patients with congenital heart disease beyond child-bearing age. Echocardiography and cardiac magnetic resonance imaging (CMR) provide safe methods of evaluating the cardiovascular system during pregnancy. In this chapter, we will review the normal physiologic changes of pregnancy and the utility of echocardiography and CMR in evaluating cardiovascular disease in the pregnant patient with a clinical case example.