ABSTRACT Objective To analyze and explore the value of transesophageal echocardiography in perioperative period of right heart occupying lesion. Methods The results of echocardiography in perioperative period and clinical features of 40 patients who had been preliminarily diagnoesed as having right heart occupying lesion were retrospectively analyzed, and 35 cases were compared with the surgical and pathological results. Results Except 5 crista terminalis，there were 25（62.5%）heart tumors，6（15%）thrombosis and 4（10%）neoplasms. Among the 25 patients，21 ( 84% ) patients were confirmed as having primary heart tumors，including 18 (85.7% ) benign and 3 (14.3% ) malignant；4 (16%) patientswere confirmed as having secondary neoplasm including 2（50%）benign and 2（50%）neoplasms. Although there are misdiagnosis，TEE is still consistent with the diagnostic sensitivity of TTE in preoperative. The diagnostic accuracy of TEE is higher than TTE and it has a better imaging effect in lesion detail. Real-time three-dimensional can provide more intuitive and vivid information. Conclusion TEE is better than TTE in preoperative diagnosis，intraoperative monitoring and postoperative follow-up of right heart occupying lesion.