Sixty-seven patients were examined with a small portable echocardiograph in Wad Medani Teaching Hospital in central Sudan. The cardiac alterations detected in the referred patients, namely valvular disease and pericardial effusion, suggested a high prevalence of inflammatory heart disease in this area. Other findings were dilatative cardiomyopathy, congenital heart disease, mitral valve prolapse and a cardiac mass. Echocardiographic examination of patients with advanced hepatosplenic schistosomiasis revealed no evidence of cardiac alterations or abnormal right heart function. For echocardiography a general purpose ultrasound scanner, as defined by the World Health Organization, was used, additionally equipped with M mode facilities. It was concluded that echocardiography is applicable even in remote tropical areas and that its value, considering costs, therapeutic consequences and clinical benefit in developing countries, can be substantial. It was particularly helpful with pericardial disease.