Echocardiography is along with computer tomography of the brain and sonography of the carotid arteries one of the basic examinations in patients with cerebrovascular attacks. Transthoracic echocardiography is performed in all patients with cerebrovascular attacks. Transoesophageal echocardiography is indicated in patients with atrial fibrillation, dilatation of the left atria, with an artificial valve or in young patients with an otherwise obscure cerebrovascular attack. The echocardiographic finding can decide in a fundamental way on the indication for anticoagulation treatment in these patients and thus reduce markedly the risk of a relapse of a cerebrovascular attack.