BACKGROUND AND OBJECTIVE: Handheld echocardiography may be a powerful diagnostic tool in the emergency room. However, its usefulness in this environment when it is performed by medical personnel with a basic training in echocardiography remains to be clarified. PATIENTS AND METHOD: A cardiologist with expertise in echocardiography and a cardiology fellow with basic training evaluated 33 patients admitted in emergency using a handheld device. RESULTS: The echocardiogram led to a change in the diagnosis and treatment in 27% and 46% of patients, respectively, allowing an early discharge in 49% of cases. The agreement between the two observers was acceptable. CONCLUSIONS: Portable echocardiography is a useful tool in emergency rooms and may be reliably performed by medical personnel with basic training in echocardiography.