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Echocardiography is a noninvasive technique for the investigation of cardiac disease with reliable levels of accuracy. Echocardiographic services commenced in the cardiac unit of the University of Port-Harcourt teaching hospital in southern Nigeria in April 2000. This study aims to report our experience with the procedure over a 12 month period as well as the spectrum of clinical cases diagnosed at our center.This is a cross-sectional study carried out at the cardiology unit of the department of internal medicine of the University of Port-Harcourt teaching hospital in southern Nigeria between May 2009 and April 2010. This was performed with the ALOKA- 400R machine using two dimensional, M-mode, color flow and tissue Doppler protocols.Two hundred and thirty-four consecutive patients, 119 males and 115 females, were examined during the study period. Their ages ranged from 10 to 96 years with a mean of 49.69 +/- 16.5 years. One hundred and twenty-four patients (53%) had hypertensive heart disease, 20 (9%) had rheumatic heart disease while 13 (6%) had dilated cardiomyopathy. Hypertrophic cardiomyopathy, pericardial effusion, intracardiac tumors, cor pulmonale, arrhythmogenic right ventricular dysplasia, infective endocarditis, prosthetic heart valve, aortic arch aneurysm were present in less than 5% of the participants. The echocardiography was inconclusive in 3 (1%) while 49 (21%) had a normal study.Hypertensive heart disease was the largest echocardiographic diagnosis at our center and is one of the most important noncommunicable diseases responsible for increased morbidity and mortality among our patients in Nigeria. More work needs to be done to increase awareness about, and treatement for, hypertension in order to prevent its complications.