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A single imaging modality for the assessment of coronary artery disease has fundamental limitations that may impair a complete and detailed evaluation of coronary pathology. In an attempt to overcome these drawbacks, novel hybrid, multimodality catheters that integrate complementary imaging technologies have been developed to provide a more comprehensive profile of the underlying vascular disease state. Recent studies have introduced dual-probe devices combining IVUS imaging with optical coherence tomography (OCT) for an improved evaluation of coronary lumen morphology and vessel wall pathology. Furthermore, IVUS and OCT probes have been individually combined with chemical near-infrared spectroscopy (NIRS) and molecular near-infrared fluorescence (NIRF) imaging in an effort to increase the specificity and sensitivity of intravascular imaging to detect coronary disease pathobiology. Additional hybrid catheter imaging technologies such as photoacoustics and fluorescence lifetime imaging are promising new alternative technologies. The aim of this chapter is to review the emerging multimodal imaging approaches for the coronary arteries and describe their ability to overcome the inherent limitations of stand-alone imaging. Advances of multimodality intravascular imaging in the context of clinical applications will be discussed, together with the technical challenges for their successful translation.