Most three-dimensional (3-D) echocardiography (3-DE) systems today are based on off-line methods where a large number of cross-sectional 2-D scans have to be acquired sequentially before a 3-D image can be reconstructed. Because acquisition is done step-by-step based on ECG triggering plus respiratory gating, this introduces motion artefacts and takes significant acquisition time. Another 3-D approach is based on 2-D transducers and parallel beam-forming. Such a system is very complex. In this manuscript, a fast continuously-rotating scanning unit, based on a 64-element phased-array transducer, is described. Typical rotation speed of the 3-D unit is 8 rotations per s. Therefore, 16 3-D volume datasets can be acquired per s in real-time. The first clinical examples as acquired with this probe are presented.