The morbidity of congenital heart disease, acquired heart disease and cardiomyopathy in children is increasing. The evaluation of cardiac structure and function in children is an important factor in determining treatment plan and judging prognosis. The traditional echocardiography often express the cardiac structure and function by measuring the absolute values of the individual heart. But it is easy to cause judgment bias in the development and growth children. The question can be solved with a statistcal method by converting the echocardiographic measurements into the Z scores after the correction of body surface area. The application progress of echocardiography Z scores in pediatric cardiac disease diagnosis and treatment were reviewed in this article.