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Transoesophageal echocardiography (TOE) is an imaging technique that uses ultrasound waves to visualize the heart from within the esophagus. This method is an extension of transthoracic echocardiography (TTE), with the primary advantage being higher-quality images of the heart's structures due to the absence of atmospheric interference from the chest wall.

During a TOE procedure, a transducer is inserted into the esophagus, typically through the mouth and down the throat, where it is then positioned alongside the esophagus to emit ultrasound pulses. The reflected waves are then received by the transducer and processed to produce high-quality, real-time images of the heart, allowing cardiologists to visualize its structures and chamber functions.

The esophageal positioning of the transducer provides several benefits for viewing, including the lack of chest wall interference, the ability to visualize critical parts of the heart from within the chest, and the possibility of multiple imaging planes simultaneously. This renders TOE particularly useful in diagnosing patients with structural heart disease, those undergoing cardiac surgery, or in situations requiring Friedberg's root view.

Additionally, TOE serves as a complement to TTE, teleradiology, and radiographic imaging techniques, such as X-rays and computed tomography. It is an important tool in the evaluation of a number of cardiac abnormalities and is most frequently utilized by anesthesiologists, cardiologists, and emergency physicians in hospitals or during emergency procedures.