The assessment of left ventricular size is a fundamental component of echocardiography. This is typically performed by measuring the end-diastolic diameter of the left ventricle in the parasternal long-axis image. There are published norms for end-diastolic diameter, as well as thresholds that correspond with mild, moderate and severe left ventricular enlargement. Despite the reliance on end-diastolic diameter to determine left ventricular size, end-diastolic diameter does not always accurately reflect the left ventricular end-diastolic volume. This is especially the case in remodeled ventricles associated with aortic or mitral insufficiency. As left ventricular volumes continue to become easier to obtain, with improved accuracy and reproducibility, when will they become the primary echocardiographic technique for assessing left ventricular size?