Alzheimer disease (AD), the most common cause of dementia in the elderly, is a progressive neurodegenerative disorder, associated with deterioration in cognition and behaviour. With the availability of newer drugs for symptoms treatments there is a general agreement to the need of an early diagnosis and an the development of new sensitive tools, to identify and/or monitor early cerebral changes, suggestive for AD. CT and MRI are recommended for routine evaluation, in order to exclude treatable causes of dementia and to exactly evaluate the degree of cerebral atrophy and the presence of parenchymal signal abnormalities. Functional imaging, including PET, SPECT and functional MR techniques, are able to investigate physiological cerebral function, such as blood perfusion, metabolism, activation, molecular composition and water diffusibility, and have the potential to detect subtle pathological changes earlier during course of disease. MRI can provide both an accurate morphological assessment and a functional evaluation. Further investigations are needed to precisely define which will be the role of the different MR techniques. Most likely an exhaustive evaluation of AD will include information obtained by conventional and functional imaging, combined with clinical, laboratory and genetic findings.