Abstract： Background: Echocardiography has been shown to play an important role in management of critically ill patient. We then present a study of the impact of echocardiography done by well trained intesnsist on management of patients in intensive care unit (ICU). Method: In this retrospective clinical study, both transthoracic (TTE) and transesophageal echocardiogram (TEE), performed on our ICU from August 2009 to May 2010. We recorded patient characteristics, indication for the echocardiogram, complication of TEE and any change in management that occurred as a result of the exam. Result: 142 echocardiograms were performed in 82 patients, Including 86 TTEs and 56 TEEs. Indication for echo including hemodynamic instability (76%), suspected cardiac effusion (7%), pulmonary embolism (5%), infectious endocarditis (3%), refractory hypoxia (2%) as well as atrial fibrillation (5%). Management was changed directly as a result of echocardiogram exam in 66% of studies. Changes included change in inotrope or drug therapy, fluid administration and surgical consultation. Conclusions: Echocardiography may have a significant impact on the management of patients in the general ICU.