Despite continuous improvements in diagnostic cardiology techniques, echocardiography remains the cornerstone for noninvasive cardiovascular assessment of the pregnant woman with heart disease or suspected cardiac abnormality. Reversible physiological cardiac remodeling of pregnancy associated with changes in valve patency or transvalvular flow pattern can be suitably assessed by the complementary use of quantitative pulsed- and continuous Doppler and qualitative color Doppler technology. These techniques are also useful for a better understanding of the pathophysiology of the hemodynamic consequences of fixed valve stenosis during pregnancy with respect to the labile nature of gradients resulting from variable loading conditions as occurs during pregnancy. Recent and specific areas of clinical use including cardiac output estimation, contrast echocardiography minimizing radioscopy during cardiac catheterization, and transesophageal echocardiography for selection of patients with mitral stenosis suitable for percutaneous catheter valvotomy illustrate the large spectrum of capabilities of this versatile method during pregnancy. (ECHOCARDIOGRAPHY, Volume 13, March 1996)