A discussion is provided of the possibilities of imaging biomarkers and other strategies for improvement of the drug discovery and development process in all stages. A new field characterized as imageonomics is evolving quickly and uses imaging analysis technology that sheds new light on disease progression by enabling the precise measurement of small changes in structure and function over time. The field opens a new door to disease progression knowledge, and the measurements used in the field are called biomarkers. They have been pinpointed by Food and Drug Administration (FDA) as tools with potential for each stage of drug development, beginning with preclinical research and progressing through the approval process. Janet Woodcock, director of the FDA Center for Drug Evaluation and Research, stated at the Fifth National Forum on Biomedical Imaging in Oncology that there is huge potential for the use of imaging in drug development. Leading pharmaceutical companies, including Pfizer are learning the large potential for medical imaging in drug discovery and development to eliminate the delta between the growing basic sciences and the less active applied sciences. Topics covered are improvements needed, importance of automation, functional imaging techniques, neurology and cardiology applications, assessment of method of action, biomarkers, translational medicine, and application of medical imaging to pre-clinical research.