Endovascular techniques for repair of vascular lesions are developing rapidly. Imaging modalities are critical in this evolution from several perspectives. Device development and evaluation rely on precise imaging to ensure fixation of devices, isolation of lesions, and assessment of healing at various intervals. Clinical implementation of endovascular techniques requires a spectrum of imaging methods to choose patients appropriately for procedures, to deploy devices expediently and precisely, and to evaluate long-term efficacy in a minimally invasive manner. This paper reviews the utility of available imaging methods for performing these assessments.