The variability of serially recorded 2-dimensional echocardiograms in normal subjects was determined. During a 2-week period, 10 normal subjects underwent echocardiography 5 times, in 2 laboratories, with use of different ultrasonographs. The video recordings were analyzed using a computer image analysis system (Quantic 1200) to provide standardized left ventricular short-axis areas and area ejection fraction (EF). Left ventricular volumes and volume EF were calculated. The 95% confidence limits of the percent difference for end-diastolic area and volume between 2 samples in a given subject were +/- 16.8 and +/- 16.7%, respectively. The limits for end-systolic area and volume were +/- 15.8 and +/- 17.0%, respectively. The 95% confidence limits for differences of area and volume EF between 2 recordings were +/- 12.8 and +/- 9.7%, respectively. No correlation was found between clinical grade (image quality) and the variability of area measurements. A good correlation (r = 0.98) was found between area and volume EF for any given subject over the 5 observations. These confidence limits are narrower than those previously recorded.