We have discussed the evolution of selected areas of echocardiography in an attempt to illustrate the capabilities and limitations of this method of study. As information has accumulated, some concepts of the specificity of certain echocardiographic patterns have had to be revised. Awareness of the potential for false positive and false negative results has increased rather than decreased the usefulness of the echo method. Equipment deficiencies which existed in past years have largely been corrected, thereby reducing the likelihood of repeating some of the earlier mistakes. Two years ago, we suggested that more patients with left ventricular disease should be studied, the results from different laboratories should be compared, a large number of patients with congenital disease should be evaluated, and the limitations of the technic be more precisely defined. Obviously much has been accomplished in all of these areas. Much more can be done. There is every reason to believe that the next few years will bring many new and important developments in diagnostic echocardiography.