Hypertension is a major cardiovascular (CV) risk factor and elevated blood pressure poses a significant burden for the whole CV hemodynamics. Along the last decades different techniques and resources have been developed, including ultrasound´s M-mode and B-mode, spectral Doppler, tissue Doppler and color Doppler. Techniques from newer resources as speckle tracking, twist and tridimensional ultrasound are continuously being inserted in the echocardiography labs routine around the world. Many of the older and newer techniques interpretation have a subject component from the echocardiographer. The clinician must have minimum technical echocardiography knowledge and assess if the echocardiogram data match clinical and other exams data. Systemic arterial hypertension leads to morphologic and hemodynamic changes in the heart. These changes are signals of progressive damage along the years. Echocardiography is a powerful tool to assess these diagnostic and prognostic information.