Aortic valve disease, encompassing aortic stenosis (AS) and aortic regurgitation (AR), is a common heart valve pathology worldwide, particularly among the aging population. Effective management of aortic valve (AV) disease requires a thorough understanding of the underlying mechanisms, precise valve severity grading and hemodynamic impact on the cardiovascular system. Aortic Stenosis (AS) is characterized by restricted aortic valve opening, primarily caused by degenerative calcification, congenital abnormalities, or rheumatic heart disease. Aortic Regurgitation (AR) is the abnormal blood backflow through the aortic valve, leading to increased pressure and volume load on the left ventricle. This hemodynamic burden can cause significant pathological changes in the left ventricle and the cardiovascular system. Initial evaluation of AR includes a detailed assessment of the aortic valve and ascending aorta, identifying the etiology and mechanism behind the valve dysfunction, grading the severity (qualitatively and quantitatively), and assessing the hemodynamic effects on the ventricles and pulmonary systolic pressure. Echocardiography is the primary imaging modality for the diagnosis and management of AV disease. In this chapter, we will discuss the role of echocardiography in a patient with AV disease and how to approach the patient with discordant echocardiographic parameters.