2D echocardiography is a great advance in the study of left ventricular aneurysms. The wide field of visualisation and the numerous planes of examination obtained from different transducer positions allow precise spatial orientation and reliable analysis of regional wall movement. An aneurysm appears as a clear and constant bulge of a segment of left ventricular wall in both diastole and systole. Antero apical aneurysms are the commonest variety. The sensitivity and specificity of 2D echo in the detection of ventricular aneurysms are high. Thrombosis within the aneurysmal bulge may also be detected (33-38%). Pseudo-left ventricular aneurysms are easily identified as a chamber communicating with the ventricle by means of a narrow neck; the width of this neck is the main echocardiographic feature differentiating pseudo and true ventricular aneurysms. 2D echocardiography gives valuable information on the state of the remaining contractile area, an important prognostic factor when surgical resection of the aneurysm is being considered.