Pericardial diseases and pericardial effusions are rather frequent conditions. Pericardial effusions are generally not diagnosed because we rarely predict their existence. Echocardiography is the most sensitive and specific diagnostic method in discovering and determining the extent of pericardial effusion. It is also important for follow up of the patients and the effect of its treatment. It is non-invasive, simple and harmless diagnostic method. In our study 50 patients with pericardial effusions were assessed. They were classified by the aetiology of the effusion and clinical symptoms. Viral effusions accounted for 14% of cases, neopalstic 18%, tuberculosis 6%, uraemia associated effusion 16%, AMI 10%, rheumatic fever 4%, SLE 10%, Dressler syndrome 4%, rupture of Valsave sinus into pericardium 2%, traumatic 4% and pancarditis was present in 4% of cases. Cardiac tamponade occurred in 8% of patients and all cases were treated by ultrasound giuded pericardial puncture. It has to be stressed that echocardiography is of indisputable benefit for diagnosing pericardial effusions but it has very low specificity concerning morphological changes when defining the aetiology of the disease.