A cylindrical ultrasonic transducer on a catheter tip lodged in the cleft between the free wall of the right ventricle and the interventricular septum provides an easily measured echo from the posteroinferior left ventricular epicardial surface. The sonic path represents a diameter of the left ventricle at approximately its largest cross-sectional area. Experiments in six dogs demonstrated that measurements by ultrasound agree within ±6% with simultaneous radiographic measurements of left ventricular diameter. Procedures designed to alter left ventricular volume were employed in 14 dogs to clarify the physiologic meaningfulness of the left ventricular diameter measured by ultrasound. Both end-diastolic and end-systolic diameter increased with anoxia, with sudden injections of saline into the left ventricle, after propranolol, and after inflation of a balloon in the thoracic aorta. These diameters decreased with isoproterenol, with increased heart rate, and after inflation of a balloon in the inferior vena cava. The present technique provides accurate and physiologically meaningful estimates of left ventricular diameter. Ventricular diameter measurements obtained during cardiac catheterization should permit assessment of ventricular distensibility and of ventricular function.