In this article the pertinent literature regarding neuroimaging in dementia is reviewed. Special attention is given to the use of CT and MRI to visualize the hippocampal area for an early diagnosis of Alzheimer's disease. It is concluded that CT and MRI both can be used for exclusion of treatable causes of dementia. This yields the highest diagnositic value in atypical dementia. For Alzheimer's disease, finding rapid enlargement of the lateral ventricles over time or hippocampal atrophy may strongly support the diagnosis. With respect to SPECT the initial enthousiasm has been replaced by scepsis. The greatest benefits seem to lie in the support of the diagnosis of Alzheimer's disease in younger patients, possibly in fontal lobe dementia, or when there is serious doubt regarding the diagnosis. Adding SPECT to MRI or CT seems not to result in a higher sensitivity for Alzheimer's disease, in an unselected population.