Cerebral small vessel diseases (CSVD) constitute a rather heterogenous group of diseases characterized by pathological changes of the small cerebral vessels. They account for 20 to 30% of all ischemic strokes. While some CSVD are restricted to the cerebral vessels, others represent systemic diseases and also lead to extracranial manifestations. No widely accepted classification of these diseases exists, to date. However, it is reasonable to distinguish the very common sporadic CVSD from a variety of rare, hereditary forms. The first part of this review focuses on general MR imaging findings in CSVD. Characteristic imaging signs of the specific disease entities, i. e. degenerative microangiopathy, sporadic cerebral amyloid angiography, CA-DASIL, Fabry's disease, hereditary cerebral amyloid angiopathies, and COL4A1-related cerebral small vessel diseases are detailed in the second part of the review.