Intracardiac echocardiography (ICE) is increasingly being used to guide percutaneous interventional procedures, principally the closure of interatrial septal abnormalities, and to support electrophysiological procedures. Clear views of intracardiac structures can help a number of other procedures, such as myocardial biopsy and paravalvular leak closure. The main advantages of ICE over transoesophageal echocardiography during closure of atrial septal defects are that the use of ICE eliminates the need for a general anaesthetic, affords clearer imaging, shorter procedure times and reduces hospital stays and radiation doses. The principal disadvantage is the additional cost of the catheter, though this can be offset by improved turnaround times and reduced personnel costs.