Nuclear magnetic resonance (NMR) imaging techniques have been applied to the observation of tissue sodium-23 in normal and ischemic canine myocardium. To produce a region of ischemia and infarction in the myocardium, in six dogs a coronary artery was subjected to 1 hour of surgical occlusion followed by 1 hour of reperfusion. The dogs were then killed and sodium-23 NMR images of the excised hearts were obtained using a high field NMR imaging system. These images were compared with tissue sodium contents measured by flame photometry. The regions of ischemic damage were clearly visible as areas of increased sodium NMR signal on the three-dimensional images. A good correspondence was found between the relative intensity of the sodium signals and the sodium contents of normal myocardium and myocardium subjected to coronary artery occlusion and reperfusion. The data suggest the feasibility of NMR sodium imaging to detect the location and extent of myocardial damage in patients with coronary artery disease.