Congenital abnormalities of the thoracic systemic and pulmonary arteries can occur in isolation or in the setting of a complex cardiovascular malformation. Severe or complex vascular defects are usually diagnosed and corrected in childhood. Infrequently, anomalies of the systemic and pulmonary arteries present during adulthood. After correction of a cardiovascular malformation most children survive into adulthood. In adults, the most common indication for imaging is to evaluate post-treatment sequelae. Understanding the underlying pathology and possible complications that may occur during follow-up is essential for planning imaging studies. Furthermore, knowledge on the different imaging modalities, including their strengths and limitations for assessing anomalies of the systemic and pulmonary arteries, is important.