Introduction: Carcinoid heart disease is observed in 3–4% of all patients with a neuroendocrine tumor and in 40–50% of those with a carcinoid syndrome [1, 2]. Details on well differentiated neuroendocrine jejunal-ileal tumors have already been discussed in the ENETS Consensus Guidelines and the reader is referred to these Guidelines . Here technical questions and quality management for the diagnosis and follow-up of carcinoid heart disease will be discussed. Involvement of the tricuspid leaflets grade 2–3 occurs in 90%, a stenosis of the pulmonary leaflets in 50%, while regurgitation is seen in 81% of the patients during the course of the disease [4, 5] . Carcinoid heart disease is a relatively late manifestation of neuroendocrine tumors; however, it has an important impact on the prognosis of these patients. Thus, early diagnosis and treatment is mandatory in each patient with a carcinoid syndrome. Echocardiography is the gold standard for detection of carcinoid heart disease. This article will concentrate on technical details for echocardiography. The information provided should help those not experienced with this disease to diagnose carcinoid heart disease and provide high-quality information of echocardiographic investigations. The information provided by echocardiography will be the basis for clinical decisions and may well influence the prognosis and outcome of the patient.