Real time three dimensional echocardiography has arrived into clinical cardiology, allowing noninvasive and repeatable spatial visualisation and accurate quantification of cardiac movement and volumes. Evaluation of valvular disease and cardiac masses with three dimensional echocardiography is superior to traditional two dimensional imaging. Since transesophageal imaging is also available, three dimensional intraoperative echocardiography and monitoring of percutaneous procedures like ASD and PFO closures is now possible.