Echocardiography is the most common noninvasive tool used in assessing cardiac masses. Real-time three-dimensional echocardiography expands the diagnostic capabilities of cardiac ultrasound in assessing the location, composition, size, and relationship to other structures of cardiac masses. The improved characterization of the anatomy of the mass, in conjunction with the accurate calculation of the left ventricular ejection fraction, makes this new technology the imaging modality of choice in assessing cardiac masses.