Echocardiography is the preferred method for a comprehensive evaluation of prosthetic valve structure and function, allowing detailed assessment with two-dimensional (2D), Doppler, and three-dimensional (3D) imaging techniques. While transthoracic echocardiography (TTE) is the primary workhorse for prosthetic valve assessment, transesophageal echocardiography is complementary and is useful for additional evaluation when TTE is limited. This chapter will use illustrative examples to review the basic principles of prosthetic heart valve evaluation using echocardiography.