Left ventricular filling flow was evaluated at the mitral orifice and in the left ventricle (LV) using color flow imaging and pulsed Doppler echocardiography in seven patients with dilated cardiomyopathy (DCM) and 10 normal subjects. Using the apical approach, filling flow in early and late diastole was observed by two-dimensional color and M-mode color flow imaging, and flow velocity patterns at the mitral orifice and in the LV, 3 cm below the orifice, were analyzed by pulsed Doppler echocardiography. Color flow imaging disclosed slower movement of the inflow signals toward the apex in DCM than in the normal. With pulsed Doppler echocardiography, the delay in timing of peak velocity in the LV was distinctly greater in DCM than in the normal, although the mitral inflow velocity did not differ between DCM and the normal. The width of the filling flow, the rate of velocity reduction and the flow velocity in the LV did not differ between DCM and the normal. Thus, in DCM, the timing of filling flow in the LV is clearly delayed compared to the timing at the mitral orifice, and this cannot be explained solely by the mitral flow velocity pattern.