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Pediatric echocardiography is coming up in a major way, because of an increased awareness of early diagnosis and management of congenital heart diseases, especially the life-threatening ones. Pediatric echocardiography technique, though simple, requires a trained pediatric echocardiographer. It is an uncomplicated, noninvasive and low-cost technique providing a correct hemodynamic status of the heart, thus reducing the requirement of cardiac catheterization, which is invasive and expensive. With the advancement of technology, three-dimensional and four-dimensional echocardiography has been introduced. This has improved the technique to identify congenital or acquired heart disease, also having its functional implications. Hence, cardiac catheterization is used for the more complex cardiac conditions, and those requiring interventions and surgery. Also, with the introduction of functional echocardiography, the use of echo in intensive care units has increased, as its use in monitoring critically ill patients has proved beneficial which is included in the chapter of Echocardiography in Intensive Care Unit.