To determine the feasibility and accuracy of digital echocardiography for routine interpretation of two-dimensional and Doppler echocardiography, we studied 93 consecutive patients chosen at random from our daily workload. The parameters studied included cavity sizes, biventricular regional and global systolic and diastolic function, valvular structure and function, and presence or absence of pericardial disease. The results were first interpreted using quad screen, digital format cine loops. These results were then compared with the results obtained from reviewing the video-tape images. Seventy-nine patients (87%) showed complete concordance between the digital system and video tape. Among the 1156 echocardiographic parameters/measurements examined in all patients, a 99% concordance rate (normal vs abnormal) was found. Disagreements between the digital system and video tape in the patients undergoing two-dimensional/Doppler exams included mitral valve prolapse in 3, mild valvular insufficiency in 5, a small pleural effusion in 2, and a wall-motion abnormality in 3 patients. In conclusion, the use of digital technology for evaluation of routine echocardiograms appears to compare favorably with the interpretation of images using the conventional video tape. (ECHOCARDIOGRAPHY, Volume 13, September 1996)