The development and validation of biomarkers for prediction, diagnosis and tracking of progression of Alzheimer’s disease are both increasingly important. As potential pharmaceutical agents are developed for Alzheimer’s disease, their efficacy needs to be assessed. When medications become available, those subjects who may derive most benefit from such treatments need to be selected and their response to treatment monitored. As such, there has been much research into biomarkers in recent years, with many showing promise in all areas of biomarker utility. This review focuses on the potential of structural imaging as a biomarker in Alzheimer’s disease.