Background : Pulmonary embolism (PE) is a clinically important disease with high mortality if left untreated. It is often clinically undiagnosed, leading to significant diagnostic and therapeutic delays. Accurate diagnosis of PE is difficult due to variable symptoms and nonspecific electrocardiographic & radiographic findings. Pulmonary angiography has been considered as gold standard tool for diagnosis of pulmonary embolism, but it is an invasive and costly procedure with significant morbidity and mortality. However, the echocardiography is non-invasive and readily available regardless of time and place. We investigated the diagnostic utility of echocardiography in identifying pulmonary embolism. Methods : We retrospectively analyzed the recorded transthoracic echocadiography videotapes from 18 patients with confirmed pulmonary embolism from January 1996 to October 2001. As echocardiographic criteria of PE , we used the presence of any two of the following: 1) RV dilataton (RVEDA/LVEDA���0.6), 2) TR (more moderate degree), 3) Pulmonary hypertension 4) RV hypokinesia, 5) Paradoxical septal movement. Results : The most common symptom of this patients was dyspnea (83.3%), follwed in frequency by pleuritic chest pain, cough, leg swelling, hemoptysis, but no symptom is seen 11.1%. The most frequently observed electrocardiographic fining was a nonspecific ST-T change (89.3%) which may be appeared other cardiopulmonary disease in precordial leads in patients with PE. We assessed the concordance rate of positive results of echocardiography with confirmatory diagnosis tool such as spiral CT and perfusion scan of lung retrospectively, it is 77.8%. Conclusion : Echocardiography is non invasive, feasibility at bedside, available and low cost test, it may be sufficient for use as a screening test in patients with complaining unexplained chest pain and dyspnea which are developed abruptly and modality to decide immediate use of anticoagulant or thrombolytics.