Efforts have been made over the years to meet the challenge of three-dimensional (3D) reconstruction of cardiac structures. Succeeding in 3D reconstruction of the aortic valve and through it achieving better understanding and possibly better quantification of aortic stenosis severity is the main purpose of using such an imaging tool. The importance attached to it over the years is related mostly to the expectation of both clinicians and researchers not only for better and more complete imaging of its shape, but also for optimal demonstration of the valve motion and through it towards better understanding of valve function in health and disease. This review deals with 2 main aspects regarding 3D echocardiography: 1). three-dimensional methods and general principles and 2). the special relevance of 3D reconstruction to the stenotic aortic valve.