Although most clinical decisions about timing of intervention remain based on symptoms or evidence of progressive ventricular dysfunction in valvular regurgitation, several available Doppler techniques can give confirmation of the presence of significant insufficiency. For these reasons, the 2D echocardiographic and Doppler evaluation has become an integral part of the diagnostic and clinical management of these patients. These imaging techniques are still in their infancy, however, and the exact relationship between jet appearance and clinical and hemodynamic implications remains to be defined. Newer approaches to color flow display of Doppler velocity information, such as power mode, quantification of jet momentum, and kinetic energy mapping may provide a better understanding of the dynamic nature of valvular regurgitation. In the future, Doppler recordings may provide the basis for a more sophisticated understanding of the hydrodynamics of valve dysfunction.