Recent updates in the field of echocardiography have resulted in improvements in both image quality and techniques allowing echocardiography to maintain its position as the primary non-invasive imaging modality. In particular, the development of new ultrasound contrast agents and imaging techniques have now made possible the assessment of myocardial perfusion. Myocardial contrast echocardiography utilises acoustically active gas filled microspheres (microbubbles), which have rheology similar to that of red blood cells. The detection of myocardial perfusion during echocardiographic examinations permits simultaneous assessment of global and regional myocardial structure, function, and perfusion, enabling the optimal non-invasive assessment of coronary artery disease. Myocardial contrast echocardiography is equally adept in assessing chronic coronary artery disease as well as acute coronary syndromes. Furthermore, its use is not limited solely to diagnostic assessment. Preliminary evidence suggests that targeted microbubbles may be useful in enhancing delivery of genes / drugs and in clot lysis.