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The identification of cognitive markers for bipolar disorder (BD) may lead to the development of personalized preventative and therapeutic approaches for individuals at high risk to develop BD. This chapter summarizes recent structural and functional imaging findings in individuals at high genetic risk for BD. We also include cognitive studies using computerized and pen-and-paper tests investigating nonemotional (“cold”) and emotion-laden (“hot”) facets of cognition. Although few studies have focused on young high-risk individuals, preliminary evidence suggests that these subjects show alterations in regions underlying emotion regulation and cognitive control. Notwithstanding inconsistencies across cognitive studies, findings suggest the presence of verbal memory deficits, slow processing speed, and abnormalities in affective processing. Large-scale, methodologically sound cross-sectional and longitudinal studies are needed to identify reliable cognitive markers of vulnerability in youth at risk for BD.