Electrocardiography (ECG) in all its forms, from 12-lead ECG to long-term monitoring, is considered, an old and increasingly irrelevant test in this high technology era. This article reviews the clinical utility of this tool and argues that the obsolescence is due to an increasing inability to read electrocardiographic tracings. The usual interpretative pitfalls are discussed and a logical approach is proposed with illustrative examples. Finally, the concept of precision ECG is presented and its meaning reviewed.