TEE has been used in the past 13 years to examine the heart and thoracic aorta, and recently the clinical utility of TEE has greatly expanded to include its use in a variety of thoracic trauma injuries. We retrospectively reviewed the use of TEE in our institution from June 1994 to June 1995. Sixteen patients underwent TEE for a variety of indications, including traumatic aortic dissection, penetrating wounds to the precordium, retrieval of a foreign body, valvular trauma, and postoperative evaluation of cardiac repair. TEE affected patient treatment decisions in all of these cases. As a diagnostic modality and as a guide to specific therapy, TEE was safe, expedient, accurate, and highly valuable in the evaluation of patients with trauma to the heart or great vessels.