In an effort to increase the safety of sedated procedures, there is a recent trend to increase preprocedure fasting times. However, optimal fasting times have never been established for a sedated echocardiogram. We retrospectively analyzed 334 patients divided into 2 groups. Group 1 (140 patients) had fasting times less than 2 hours, whereas group 2 (184 patients) had fasting times more than 2 hours. When the entire population was considered, there was no difference in efficacy between the 2 groups (P =.08). However, in patients younger than 6 months, group 2 had decreased efficacy compared with group 1 (P =.03). There were no major complications in either group. There was no difference in the rate of minor complications between the 2 groups. Our study concludes that longer fasting times are less efficacious in children younger than 6 months, and do not improve safety.