Despite the fact that three-dimensional echocardiography (3DE) has been available for many years, its utilization on a routine clinical basis has been rather limited. However, recent improvements in image quality, semi-automated quantification, better workflow, and other developments such as fusion imaging, have now accelerated the integration of 3D imaging into routine echo practice. In this chapter, we have reviewed the standard and well established applications of the technique such as volumetric chamber analysis and 3D evaluation of valvular pathology, as well as highlighting some of the exciting new developments such as the use of artificial intelligence and photo-realistic visualization. these newer techniques will undoubtedly help ensure that 3D echocardiography plays a pivotal role in contemporary cardiac imaging leading and cutting edge patient care.