Echocardiography is probably the single most useful tool available for assessment of cardiac disease, with the possible exception of physical examination. Echocardiography is safe and versatile, giving information about both cardiac structure and function. Nevertheless, echocardiography findings should always be interpreted in the context of other clinical findings and all echocardiography results should be integrated to produce a plausible ‘story’. In other words, physical examination findings, chamber enlargement and Doppler echocardiography findings should all be consistent with one another. The echocardiographer needs to be more than just a good ultrasonographer. In addition to possessing the technical skills to record standard imaging planes in a variety of patients, the echocardiographer should have a good understanding of cardiac pathophysiology and of the haemodynamic effect of different diseases and lesions. Although a standardized protocol should form the basis of every echocardiography study, some ability to ‘think on one’s feet’ enables additional questions to be answered during the course of the examination. The following topics are addressed: Types of echocardiography; Technique; Chamber measurements; Systolic function; Valve function; and Interpretation.