3D Echocardiography replaces the need for mental reconstruction involved in 2DE and offers most complete and comprehensive assessment of cardiac pathologies including valvular heart disease. It can also demonstrate the valvular pathologies as seen in the real life. Most studies using 3DE have focused on the evaluation of the mitral valve and aortic valve. 3DE in evaluation of mitral valve disease is adventitious as the structure of the diseased valve can be evaluated and severity of mitral stenosis and regurgitation can be assessed. Aortic stenosis and regurgitation can also be assessed and quantified with 3DE. Tricuspid and pulmonary valves are less amenable to 3D imaging. Left atrial volume has been shown to be accurately quantified by 3D echocardiography and correlate well with MRI and appear to have accuracy comparable to 2D left atrial volume methods. 3D TEE represents a major progression in the evolution of echocardiography and has the potential to become the central imaging tool for guidance and follow-up of surgical and interventional procedures of the mitral valve.