Imaging is a crucial component in the workup of any patient with epilepsy. Traditionally, imaging evaluation has been performed with magnetic resonance (MR) imaging, with high-resolution sequences at 3 Tesla (T). High-field MR scanners (7T and above) have been used for research, and recently 7T scanners have become available clinically. MR imaging at 7T offers improvements in signal-to-noise ratio and spatial resolution that afford substantial benefits in identification, visualization, and characterization of brain lesions and abnormalities in patients with epilepsy. In this chapter, we review the application of intracranial 7T MR imaging to the assessment of patients with epilepsy, with an emphasis on clinical cases in which high-field imaging enhanced diagnosis and treatment, and review some of the limitations of this technology.