Percutaneous closure of paravalvular leaks has grown into becoming a widely considered option for treatment of hemodynamically significant regurgitation in patients with valve prosthesis. Guidance provided by the use of cardiovascular imaging techniques before and during the intervention has proved its relevance to improve accuracy and, with it, the outcome of the procedure. It has also been essential in the successful evolution of the technique and the development of devices specifically designed for it. The present work reviews the role of imaging before, during and after treatment of perivalvular prosthetic leaks and the most recent and significant advances in it.