Assessment of prosthetic heart valves (PHV) requires an in-depth knowledge of the types of valves being implanted, their hemodynamic profile in vivo and in vitro and clinical consequences and follow-up parameters which impact the long-term prognosis of such patients. The implications of improper approach to assessment of prosthetic heart valves can be catastrophic. This chapter covers the types of valves, prosthetic heart value evaluation, two-dimensional echocardiography (2D ECHO), limitations and pitfalls of echocardiography in assessing PHV, thrombus, pannus, pathological, prosthesis-patient mismatch, transprosthetic hemodynamics, Doppler in evaluation of PHV, velocity contour and acceleration time, Doppler velocity index, special features in relation to PHV evaluation, and prosthetic valve regurgitation.