Contrast echocardiography is considered by many as the Holy Grail for the assessment of heart disease, including coronary artery disease, structural abnormalities and cardiomyopathies. Although contrast agents have been severely criticized at times, they are now officially implemented into an extended variety of clinical applications, as illustrated by the American and European echocardiographic societies published consensus statements. The current review highlights contrast major clinical applications under the light of current literature data.