Cardiac ultrasound artifacts and pitfalls are common findings in our daily clinical practice. Artifacts are misrepresentations of the actual images, which may lead to the misinterpretation of the images. Artifacts are inevitable as they originate from the physical principles of ultrasound. It is important to recognize pitfalls and artifacts and minimize or mitigate artifacts as they can lead to inappropriate diagnostic or therapeutic interventions. Artifacts are the Achilles’ heel of all cardiac imaging. This section aims to categorize and elucidate common cardiac ultrasound artifacts and how to diagnose and mitigate them. Some of these artifacts can have life-threatening impacts if misdiagnosed. However, most artifacts happen in a predictable way due to violation of cardiac ultrasound assumptions.