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Aims: The European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee performed a global survey on radiation exposure in interventional echocardiography. The survey aimed to collect data on local practices for radioprotection in interventional echocardiography and to assess the awareness of echocardiography operators about radiation-related risks., Methods and Results: A total of 258 interventional echocardiographers from 52 different countries (48% European) responded to the survey. One hundred twenty-two (47%) participants were women. Two-thirds (76%) of interventional echocardiographers worked in tertiary care/university hospitals. Interventional echocardiography was the main clinical activity for 34% of the survey participants. The median time spent in the cath-lab for the echocardiographic monitoring of structural heart procedures was 10 (5-20) hours/month. Despite this, only 28% of interventional echocardiographers received periodic training and certification in radioprotection and 72% of them did not know their annual radiation dose. The main adopted personal protection devices were lead aprons and thyroid collars (95% and 92% of use, respectively). Dedicated architectural protective shielding was not available for 33% of interventional echocardiographers. Nearly two-thirds of responders thought that the radiation exposure of interventional echocardiographers was higher than that of interventional cardiologists and 72% claimed for an improvement in the radioprotection measures., Conclusion: Radioprotection measures for interventional echocardiographers are widely variable across centres. Radioprotection devices are often underused by interventional echocardiographers, portending an increased radiation-related risk. International scientific societies working in the field should collaborate to endorse radioprotection training, promote reliable radiation dose assessment, and support the adoption of radioprotection shielding dedicated to interventional echocardiographers., Competing Interests: Conflict of interest: Victoria Delgado received speaker fees from Edwards Lifesciences, GE Healthcare, JenaValve, Medtronic, Novartis and Philips and consulting fees from Edwards Lifesciences, MSD and Novo-Nordisk. Elena Galli received speakers’ fees from BMS. Luna Gargani received consulting fees from Caption Health and Sanofy and writing fees from Piccin. Nina Ajmone Marsan received speaker’s fees from GE Healthcare, Philips Ultrasound, Abbott Vascular, Omron, Pfizer. Denisa Muraru received speakers’ fees from GE Healthcare, Philips, Bristol-Myers Squibb. Steffen Petersen received consulting fees from Circle Cardiovascular Imaging, Inc., Calgary, Canada. Piotr Szymanski received speakers’ fees from Novartis and Samsung., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)