The field of echocardiography has evolved due to miniaturization, from increasing functionality of high end devices to the portability of hand held devices which have a footprint similar to a smart phone.This chapter seeks to inform the reader on the fundamental capabilities and limitations of hand-held echocardiography and the types of devices available. We explore the learning requirements for all levels of users and validation studies pertinent to hand held echocardiography. A guide is provided on protocols which may be used to perform and report hand held echocardiography. We discuss the qualitative and semi quantitative methods available to maximise the diagnostic yield of hand held echocardiography. Finally we discuss the specific roles of this modality currently and its potential role in the future.Despite and perhaps because of its diminutive size, hand held echocardiography represents a revolution in the field of cardiac imaging and auscultation: For the first time since its introduction in 1816, a true hand held "stetho-scope.".