Transthoracic echocardiography (TTE) is one of the most performed cardiac examinations in internal medicine. It enables a quantitative evaluation of the cardiac morphology and function based on diameters, volumes and/or intracardiac blood flow velocity measurements. These measurements are systematically interpreted by a cardiologist and summarized into a concise and objective description that is useful for clinical management. The detail of all the quantitative measures is complex and usually hard to be directly interpreted by a non-cardiologist. This article illustrates the utility of TTE in four frequent in-hospital clinical situations, underlining not only the strengths, but also the limitations associated with this examination.