Imaging assessment of the postoperative spine is complex and depends on many factors. Postoperative imaging studies evaluate the position of implants, adequacy of decompression, fusion status, and potential complications. This article provides a review of various imaging techniques, with their advantages and disadvantages, for the evaluation of the postoperative spine. It also gives an overview of normal and abnormal postoperative appearances of the spine as seen via various modalities, with an emphasis on postoperative complications.