Advances in echocardiography have enhanced our diagnostic imaging capabilities for congenital heart defects. In addition to improved resolution of two-dimensional images, cardiac hemodynamic assessment is possible with the use of Doppler, color Doppler, and stress echocardiography. Transesophageal echocardiography has allowed intraoperative assessment of cardiac repairs, and fetal echocardiography has allowed development of the field of fetal cardiology. The developing areas of intravascular ultrasonography and three-dimensional echocardiography show promise for the future. Echocardiography continues to revolutionize our ability to diagnose congenital heart defects accurately.