The echocardiographic assessment of pulmonary hypertension must include an appreciation of the interaction between the load imposed on the ventricle by the increased resistance of the pulmonary arteries and the contractile force of the right ventricle (RV). It is a combination of these two factors that determine the right ventricular and pulmonary artery pressures. Thus, an echocardiographic assessment must include assessment of both the pulmonary arterial load and the RV function. This chapter reviews the echocardiographic tools available for assessing both arterial load and function and the interaction between the two.