Left ventricular (LV) shape has hitherto received little attention from echocardiographers; systematic quantitative observations on LV shape, apart from LV volume, wall thickness or function, have been attempted only recently. In this article, we focus on assessment of normal LV shape and changes in overall LV chamber configuration in cardiomyopathic and other dysfunctional left ventricles. The topic of LV shape of hypertrophic LV chambers is also addressed. LV shape descriptors comprise ratios of various LV measurements to each other; their values in normal and abnormal LV chambers, as set forth in recent work from our laboratory and others, are summarized Cardiologists, including echocardiographers, are not generally aware of the various geometric approaches to quantifying chamber shapes. These are briefly described, with comments on their relative suitability for application to LV shape evaluation.