Infective endocarditis continues to be a significant diagnostic and therapeutic problem. During the last two decades, transthoracic echocardiography, and more recently, transesophageal echocardiography have been used in patients with the clinical syndrome of endocarditis to detect vegetations and assess the extent of valvular damage. Certain echocardiographic findings have important prognostic implications and can help determine the timing of surgical intervention. This paper will review the role of echocardiography in the evaluation and management of patients with infective endocarditis.