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This chapter presents a standardized approach to assess the four valves of the heart: the mitral valve (MV); aortic valve; tricuspid valve; pulmonary valve. The MV is examined through four mid-esophageal and two transgastric views. The aortic valve is a semilunar valve with three cusps of similar size. The aortic root is usually easy to visualize with transesophageal echocardiography (TEE) and needs three cross-sections for a complete evaluation. The tricuspid valve consists of three leaflets, attached via multiple chordae tendineae to three small papillary muscles, a supporting annular ring, and a portion of the myocardium of the right ventricular (RV) free wall. The pulmonary valve and the main pulmonary artery can be assessed with TEE in the basal view. The standardized approach outlined in the chapter provides a useful framework for a TEE assessment of the cardiac valves.