It is generally accepted that Doppler echocardiography is the mainstay investigation for the diagnosis and management of patients with heart failure. Its noninvasive nature makes it patient friendly as well as a unique tool for repeat studies during various stages of the disease process. It provides detailed information, with high temporal resolution, on cardiac structure and function, which guide clinicians to the optimum management plan. Even if resting information fails to explain the patient’s symptoms, stress echo findings usually provide accurate explanation and guide toward direct management. We hereby discuss the use of echocardiography in heart failure in detail.