Thanks to impressive advances in the field of oncology over the last thirty years, there has been a dramatic rise in cancer survivors. Nowadays, the risk of dying from cardiovascular disease exceeds cancer-related mortality in this population. Coronary artery disease (CAD) is a major problem due to shared risk factors, an ageing population and in many cases induced and/or accelerated by antitumoral treatment during and even decades after the end of cancer therapy. On the other hand, the presence of CAD at the timepoint of cancer diagnosis largely increases the risk of any cancer therapy related cardiovascular toxicity (CTR-CVT). It is therefore of outermost importance to detect CAD before, during, and after certain types of chemo-, molecular-, and radiotherapy. Multimodality cardiovascular imaging plays a central role in this fragile population where individual risk stratification and multidisciplinary decision making is critical.