Purpose of Review <p>People with HIV (PWH) have increased risk of cardiovascular disease. Echocardiography is a widely accessible, non-invasive test that provides key information regarding cardiac structure and function. In this review, we focus on the use of echocardiography as a research tool to understand the epidemiology and pathophysiology of cardiovascular disease among PWH. We then examine the implications for echocardiographic studies in the clinical care of PWH.</p> Recent Findings <p>Contemporary cohort studies that use echocardiography to characterize cardiac function among PWH largely treated with antiretroviral therapy compared to sociodemographically similar peers suggest that the risk of cardiac dysfunction associated with HIV – including left ventricular systolic and diastolic dysfunction and right ventricular dysfunction – is lower than suggested by older studies.</p> Summary <p>Echocardiography is useful for understanding the role of HIV in cardiac dysfunction, as well as the clinical care of persons with HIV.</p>