Enlargement of left atrium (LA) has been shown to be a barometer of diastolic burden and a predictor of common cardiovascular outcomes such as atrial fibrillation, stroke, congestive heart failure, and cardiovascular death. Different methods exist for the assessment of LA size. The American Society of Echocardiography recommended LA volume and its indexed value assessed by 2-dimensional echocardiography, to measure LA size. Current findings suggest that echocardiographically determined LA size may become an important clinical risk identifier in preclinical cardiovascular disease and should be assessed as a part of routine echocardiographic evaluation.