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Cardiac MRI applications for diagnosis and follow-up of patients with acquired heart disease are constantly expanding. This review article presents an overview of the use of cardiac MRI in nonischemic acquired heart disease. The role of MRI in nonischemic acquired heart disease continues to be influenced by perceived capabilities of echocardiography. The applications discussed in this review are: myocardial diseases including cardiomyopathies, arrhythmogenic right ventricular dysplasia and myocarditis; pericardial diseases, especially constrictive pericarditis; cardiac and paracardiac masses; and valvular heart disease. Cine MR is now regarded as the preferred method for evaluation and quantification of right ventricular function. J. Magn. Reson. Imaging 2008;27:1195–1213. © 2008 Wiley-Liss, Inc.