The use of echocardiography is still far from optimal. It is difficult or impossible to ensure the 24-hour presence at a hospital of a cardiologist with experience in echocardiography. As a result other specialties are becoming familiar with this technique. Echocardiography has been recognized as of paramount importance in diagnosis, prognosis and therapeutic decisions in several diseases and therefore echocardiographic training with different levels of experience should be supported and coordinated by a reference group in such matters. The authors review some aspects of echocardiography in emergency. They emphasize the importance of continuous training and accreditation as required conditions to perform echocardiography.