Tissue Doppler Imaging (TDI) is a recent ultrasound technique allowing quantification of regional myocardial function by measurement of myocardial velocities throughout the cardiac cycle. The physical principle of TDI is based on the ability of ultrasound machines to selectively display the low velocity--high amplitude Doppler signals from the myocardial walls. Three TDI modes may be used: the pulsed wave mode, the 2D color mode and the color M-mode. Several studies have already shown that TDI is a more sensitive and specific technique than conventional Doppler echocardiography for detecting moderate myocardial alterations in different settings such as hypertrophic and dilated cardiomyopathies, ischemia and heart transplant disorders. TDI might therefore be used as an accurate technique for screening cardiomyopathies, and could also represent in the next future a useful tool for evaluating the efficacy of early cardiac therapeutic interventions.