This report shows the importance of non-invasive techniques in infective endocarditis (IE) diagnosis. ECG is quite specific in identifying perivalvular extension of infection when conduction system disease is demonstrated but has a low degree of sensitivity overall. Our casuistry (76 patients with IE) confirms the literature data about the great importance and the utility of transthoracic and transesophageal echocardiography to detect vegetation presence or complications as abscesses or valvular leaflet perforations. Therefore, these techniques are widely applied to predict major clinical events as embolism and death or to suggest a surgical therapy. Nuclear medicine studies play a minimal role. Magnetic resonance imaging appears to be an effective tool in this setting; however, because of a paucity of clinical data, its precise utility has not yet been determined.