Assessment of the bovine cardiovascular system is challenging because the position of the heart, deep in the thorax, may interfere with clinical findings. With advances in bovine ultrasonography, normal and abnormal findings of the bovine cardiovascular system have been described. Cardiovascular ultrasound can be of valuable help as a noninvasive diagnostic tool, especially when clinical findings are inconclusive. This article presents an up-to-date review of echocardiography and vascular ultrasound in the diagnosis and prognosis of the most common cardiovascular diseases in cattle.