Revival of interest to three-dimensional echocardiography during recent years was invoked by introduction of essentially novel ultrasound technology of "live" three-dimensional imaging. We introduce here the first experience of the use of three-dimensional echocardiography in Russia comprising examination of 74 patients with various pathology of the heart. Positions and sections are described allowing best visualization of pathology of cardiac valves and other intracardiac structures. Our experience shows that at present three-dimensional echocardiography should be considered to be an important supplement to standard echocardiography. However in some cases it can be the only non-invasive technique able to provide complete information on the size of ventricular and atrial septal defects, valvular and other cardiac pathology.