In this chapter, echocardiographic features of complications of acute myocardial infarction including ventricular septal rupture, ventricular free wall rupture, papillary muscle rupture, ventricular pseudoaneurysm, etc. are discussed. Real-world case examples are used to illustrate the diagnostic features of these complications in echocardiography. Indications for surgical intervention are discussed and current recommendations from international guidelines for the management of these conditions are presented.