Diabetes mellitus is a major factor contributing to the development of cardiovascular disease. As morbidity and mortality rates rise dramatically, when target organ damage develops, presymptomatic assessment is critical for the management of diabetic patients. Echocardiography is a noninvasive and reproductible method that may aid in risk stratification and in evaluation of treatment effects. Aim of this review is to analyze the echocardiographic techniques that can detect early alteration in cardiac function in patients with diabetes.