The emerging role novel echocardiographic techniques play in the practice of cardiology and how they can specifically impact care of the elderly patient are reviewed. Newer echocardiographic modalities including Doppler tissue and strain/strain rate imaging, contrast echocardiography, 3-dimensional echocardiography, and velocity vector imaging are described. Examples illustrating how these newer echocardiography modalities enhance our ability to make a variety of cardiovascular diagnoses are shown. The way in which these novel echocardiographic techniques allow for improved noninvasive estimation of left ventricular filling pressure, better diagnosis of cardiomyopathy and complications of acute myocardial infarction, better quantification of valvular heart disease, and enhance our understanding of myocardial contractile processes are reviewed. These newer echocardiographic modalities will continue to play an increasing role in the future as applications identifying ways in which they enhance cardiovascular diagnosis are discovered. ©2007 Le Jacq.