This chapter focuses on the major and practically relevant artifacts in echo spanning the various modalities of imaging—2D, Doppler, transesophageal echocardiography (TEE), contrast and 3D echocardiography. The specific artifacts, their mechanisms, recognition, examples and possible solutions are briefly discussed. Imaging artifacts commonly fall into two categories following as either visualization of non-existing ‘structures’ or alteration in size and shape of an existing structure. With advances in imaging modalities, the range of artifacts has also grown. Contrast echocardiography involves administration of ultrasound contrast agents to produce microbubbles for imaging. The primary indications are for left ventricular (LV) opacification and for LV endocardial border definition in patients with suboptimal imaging on traditional echocardiography.