In a transesophageal echocardiogram, a transducer is inserted through the mouth and down the throat into the esophagus. High-pitched sound waves (ultrasound) are sent through the transducer to produce an image of the heart and sometimes the aorta.

Normally the transducer is moved over the surface of the skin on the chest.

A transesophageal echocardiogram is often used for obese people because evaluating the heart through a thick chest wall is hard. This method allows a clear view of the valves and their ability to function. It provides a better view of heart valves than a standard transthoracic echocardiogram, but the procedure is more complicated.