The majority of acute coronary events are caused by ruptures of vulnerable atherosclerotic plaques. Accurate identification of vulnerable plaques holds great promise in optimizing treatment plans and preventing cardiac deaths in future. However, clinically available imaging technologies are not sufficient to accurately diagnose vulnerable plaques. By the combined use of complementary imaging technologies, multimodality intravascular imaging technologies can image and quantify atherosclerotic plaques, and accurately identify vulnerable plaques. In this paper, we review the development process and the technical difficulty of multimodality intravascular imaging technologies, including intravascular ultrasound-optical coherence tomography, optical coherence tomography imaging-fluorescence, optical coherence tomography-spectrometer, intravascular photoacoustic-ultrasound and optical coherence tomography-optical coherence elastography multimodality imaging technologies. The paper will conclude with future directions of multimodality intravascular imaging technologies.