Advances in cancer treatment have led to increased survival rates but also heightened risk of cardiotoxicity, either directly impacting the heart or accelerating existing cardiovascular conditions. This chapter underscores the critical role of echocardiography in managing cancer therapy-related cardiovascular toxicity (CTR-CVT). Transthoracic echocardiography (TTE) is indispensable for the early detection of subclinical cardiovascular issues, risk assessment before treatment, and ongoing evaluation during therapy. Its advantages include cost-effectiveness, widespread availability, and no ionizing radiation. TTE provides essential insights into left ventricular function, including systolic and diastolic dysfunction, and detects early myocardial injury using global longitudinal strain. It also evaluates the right heart chambers and pericardial conditions. While other imaging techniques like computed tomography and cardiac magnetic resonance offer additional diagnostic information, echocardiography remains the cornerstone for monitoring cardiac health in cancer patients. Effective management of CTR-CVT involves detailed stratification, precise diagnosis using echocardiography, and tailored therapeutic interventions to improve patient outcomes.