Three-dimensional echocardiography is the only ultrasound technique that offers the ability to image the complex right heart in its complete dimensionality. Over the years, the benefits of three-dimensional echocardiography to improve our understanding of right heart pathologies and ultimately patients’ care have emerged from numerous publications. The aims of this review article are to highlight the importance of three-dimensional echocardiography for a more accurate evaluation of the right heart structures, to discuss the most important recent developments in the field and highlight future directions and needs.