Purpose of Review: This review aims to evaluate current diagnostic and therapeutic strategies for postpericardiotomy syndrome (PPS), with a focus on the evolving role of multimodality imaging, including echocardiography, cardiac computed tomography (CCT), and cardiac magnetic resonance imaging (CMR). The review also explores the potential benefits of advanced imaging in improving the accuracy and management of PPS., Recent Findings: PPS, a common complication following cardiac surgery, presents with pleuritic chest pain, fever, and pericardial or pleural effusion. Traditional diagnostic methods like echocardiography and X-ray are increasingly supplemented by advanced imaging modalities such as CCT and CMR. These tools allow for better visualization of pericardial inflammation and effusion, aiding in diagnosis and guiding treatment. Colchicine and NSAIDs remain the most effective treatments for PPS, while the role of corticosteroids remains uncertain. Biological treatments have shown promising results in managing recurrent pericarditis. This review presents a proposed algorithm for the diagnosis and management of PPS, drawing on our institutional experience. Multimodality imaging is emerging as an essential tool in diagnosing and managing PPS. It enhances diagnostic precision, informs treatment strategies, and provides prognostic insights. As imaging technology advances, integrating these modalities into PPS care has the potential to improve patient outcomes., Competing Interests: Declarations. Competing Interests: The authors declare no competing interests. Conflict of Interest: The authors declare that they have no conflict of interest. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)