Gestational trophoblastic disease (GTD) is the general term for a spectrum of proliferative abnormalities of the trophoblast. GTD is a manifestation of an aberrant fertilization event that leads to a proliferative process and, potentially, to an invasive neoplasm. The spectrum of GTD includes hydatidiform mole, invasive mole, choriocarcinoma, placental-site trophoblastic tumor, and epithelioid trophoblastic tumor. GTD is an uncommon disease, but it is important to detect and recognize it due to the high risk of missed or delayed diagnosis. The degree of abnormality, as well as the clinical implications of the findings, should be understood to help guide management decisions of GTD. Although ultrasonography is the modality of choice for evaluating GTD, CT and MRI are useful in detecting myometrial invasion, parametrial extension, and metastasis. Because each imaging technique offers unique different aspects of GTD, it is important to understand the spectrum of imaging findings on various kinds of imaging modalities. Multimodality imaging studies may have a problem-solving role in examining GTD patients with a confusing clinical picture.