Echocardiography encompasses a number of specific imaging techniques. The two-dimensional (2-D) echocardiogram is used to identify lesions of the heart and great vessels, assess myocardial function and provide a template for guiding contrast echocardiography, colour-coded Doppler echocardiography and spectral Doppler studies. M-mode echocardiography is used to measure cardiac size and ventricular function and can be combined with contrast or colour-coded Doppler studies for accurate timing of flow events. Pulsed wave and continuous wave Doppler echocardiography display the direction and velocity of red blood cells within the heart and circulation. Continuous wave Doppler studies are used to calculate pressure gradients in the circulation. Any of the Doppler techniques can be used to identify abnormal or high velocity flow responsible for pathologic heart murmurs. Each Doppler format is complementary to the others: colour-coded Doppler is used to screen large areas for flow disturbances; pulsed wave Doppler can pinpoint regions of abnormal flow; and continuous wave Doppler quantifies the maximal velocities of blood flow across cardiac lesions. Echocardiographic studies are very useful for the diagnosis and assessment of horses with cardiac murmurs, arrhythmias, and poor exercise performance. A number of cardiac disorders can be evaluated by echocardiography, including: cardiac malformation, valvular heart disease, cardiomyopathy, bacterial endocarditis, pericardial effusion, and congestive heart failure. When combined with a careful clinical examination, exercise evaluation and results of electrocardiography, the echocardiogram provides the best overall clinical assessment of the equine heart.