The appearances of pulmonary venous flow Doppler echocardiography have been the subject of many reports. The recording is obtained by transthoracic or transoesophageal pulsed Doppler examination. The value of this parameter in the study of left ventricular diastolic function has been clearly established. The transoesophageal approach is mainly useful for quantifying mitral regurgitation and for monitoring left atrial pressure during surgery. This review of the literature describes the methods of recording and the normal appearances of pulmonary venous flow, and then discusses the different variations encountered in pathological conditions.