The traditional two-dimensional transthoracic echocardiography (2DTTE) has limitations in demonstrating the extent of pericardial thickening in constrictive pericarditis (CP) because of poor transmission of ultrasound through the thickened anterior pericardial structures. We describe a case of CP, of unknown etiology, in which transesophageal 3DTEE equalled the accuracy of cardiac magnetic resonance in demonstrating the extent of pericardial thickening in CP.