Objective To investigate the application value of intraoperative transesophageal echocardiography (TEE) in cardiac surgery.Methods Ninety-five cardiac surgery patients were monitored by intraoperative TEE. Their cardiac and macrovascular structures, functions and blood flow were completely examined and evaluated during cardiopulmonary bypass (CPB), or before/after cardiac surgery. Minimally invasive occlusion was continuously monitored and guided.Results The diagnosis was modified preoperatively in 26 patients (27.4%). Decisive intervention was performed in 42 (44.2%), while all patients received general intervention..Conclusion Intraoperative TEE can be used for preoperative modification of diagnosis, intraoperative continuous monitoring and guiding, and immediate postoperative evaluation of operative effect; also, it directs postoperative passing flatus, evaluates local and overall cardiac function and blood volume, and has important value in monitoring and evaluating the cardiac surgery.