Contrast echocardiography has developed rapidly in the past decade. With the advent of more stable contrast agents and new ultrasound imaging techniques such as second harmonic imaging and transient response imaging, contrast echocardiography has evolved to a promising non-invasive perfusion technique. Myocardial contrast echocardiography is evolving from a qualitative to a quantitative technique, and from an intra-arterial to an intravenous approach. Assessment and quantification of myocardial perfusion in acute myocardial infarction, detection and evaluation of coronary artery disease and enhancement of endocardial border for improved definition of cardiac function are examples of novel applications of contrast echocardiography being developed.