Purpose of review: This article will highlight the most important papers on structural neuroimaging in old age psychiatry. Recent findings: More and more papers deal with structural-behavioural associations, especially in the field of depression and dementia. In the former, increasing attention is paid to predictors of response to therapy. Summary: In depression the role of vascular changes slowly becomes evident. Orbitofrontal changes are associated with depression but the functional relevance is unclear. In dementia, the focus on focal degenerative processes and the interaction with vascular disease becomes evident.