Identification of high-risk atherosclerotic lesions prone to rupture and thrombosis may greatly decrease the morbidity and mortality associated with atherosclerosis. The development of magnetic resonance imaging contrast agents that specifically target components of the atherosclerotic plaque might enable non-invasive detection of high-risk lesions. This review discusses a variety of molecules present in atherosclerotic plaque that could serve as targets for specific contrast agents. Ultimately, such agents may allow the identification of high-risk atherosclerotic lesions in patients and enable treatment of these patients before lesion progression and complications.