Contrast echocardiography is a new cardiovascular angiography technology, which combines echocardiography and contrast acoustic technique, including right and left heart contrast echocardiography. Left heart contrast echocardiography is now vividly used in clinic, including left ventricular opacification and myocardial contrast echocardiography. This technology enhances the visualization of cardiac and vascular cavity, thus improving the display effect of cardiac chamber and myocardium, and can also intuitively prompt heart perfusion. The European Association of Cardiovascular Imaging and the American Society of Echocardiography were both published related guideline updates in 2017 and 2018. Clinical applications and guideline recommendations of left heart contrast echocardiography were reviewed in this paper.