According to the appropriateness criteria from the American Society of Echocardiography, the indications for transesophageal echocardiography (TEE) are:

1. When visualization of cardiac structures in not adequate with transthoracic echocardiography
2. To evaluate valvular structure and function in preparation for an intervention (surgery)
3. To diagnose infective endocarditis when there is a moderate or high pre-test probability
4. To evaluate patients with atrial fibrillation/flutter to facilitate clinical decision making in regard to anticoagulation, cardioversion or ablation.
5. Evaluation of acute aortic pathology (such as ascending aortic dissection)
6. Evaluation for cardiovascular source of embolus (frequently causing an embolic stroke) with no identifiable non-cardiac source
7. Re-evaluation of a prior TEE finding (i.e. resolution of a thrombus or endocarditis)
8. Guidance during percutaneous non-coronary interventions (i.e. atrial septal defect closure)