Whether prolonged exercise results in a transient depression in left ventricular (LV) function has been the focus of numerous studies since the 1960s. This review attempts to summarize the findings of this growing body of research. Understanding in this area has followed the advances in imaging techniques and specifically in echocardiographic technology. As such, the review focuses on evidence from the traditional echocardiographic technology (two-dimensional and Doppler measures), the more advanced technique of tissue Doppler imaging (TDI), and finally the assessment of myocardial strain and strain rate. Although many of the studies have adopted a similar cross-sectional pre- to postexercise design, there are often significant differences in terms of subject characteristics, exercise duration, and exercise modality. Accordingly, we draw together the common findings from this growing body of research in an attempt to reach a consensus regarding the influence of prolonged exercise on LV function.