Age-related white matter injury has been recognized increasingly with the improvement of brain imaging technology. Arteriosclerosis and venous collagenosis, which occur with aging, result in a spectrum of white matter changes that range from periventricular to subcortical and deep white matter hyperintensities best seen on T2 weighted magnetic resonance imaging. These white matter changes are associated not only with aging, but with hypertension and silent infarctions. Loss of brain volume and accumulation of iron in putamen occur with normal, healthy aging. This article discusses the imaging appearance of healthy aging and pathological correlates of similar appearing alterations. The imaging findings of the most common neurodegenerative disorders, Alzheimer's and Parkinson's disease, are highlighted.