3D echocardiography offers diagnostic value similar to tomographic methods with high image quality for the detailed evaluation of conditions such as mitral valve diseases, aortic valve diseases, and congenital heart defects. It is indispensable for guiding complex structural heart procedures, especially MitraClip. Furthermore, it plays a critical role in the non-surgical, transcatheter closure of paravalvular leaks originating from suture lines due to prosthetic valve complications. For such interventional procedures, 3D echocardiography is vital for accurate measurement of defect sizes and determining the most appropriate treatment strategy, also providing continuous guidance throughout the procedure to enhance safety.