This chapter focuses on upper airway imaging, and examines risk factors for obstructive sleep apnea (OSA) (both static and dynamic) and the anatomical factors that are changed when successful treatment modalities are applied. OSA is known to have a significant familial component. Volumetric magnetic resonance imaging (MRI) has been employed to investigate whether or not oropharyngeal soft tissue structures segregate in a familial fashion. These data implicate that changes in airway conformation and the size of structures surrounding the oropharynx are important identifiable risk factors for the development of OSA. Interventions which successfully improve sleep disordered breathing often have positive impacts on these same factors, which may contribute to the reduction in airway collapsibility. Imaging can be used to classify patients for the purpose of targeting treatment modalities in order to enhance the success in treating sleep disordered breathing especially in patients undergoing upper airway surgery.