Background: Open access echocardiography is widely available to General Practitioners(GP). There is little data comparing the proportion of echocardiographic studies which are abnormal in open access series with that in hospital outpatient practice. This study compares the diagnostic yield from echocardiograms performed for similar indications by open access and hospital out patient requested groups and assesses the attitudes of GPs and patients to open access echocardiography. Methods: The reports of 151 consecutive patients who had open access echocardiograms were analysed using predefined criteria for an abnormal study. The reports of 100 consecutive patients who had a new outpatient requested echocardiograms for similar indications were used as the control group. The attitudes of GPs and patients to the open access service were also assessed. Results: Fifty seven percent of patients in the open access group and 51%in the hospital requested group had abnormal studies(p >0.05). 92%of GPs who responded to the questionnaire thought the report was easy to understand while 69%thought it led to a change in patient management. 74%said a clinic referral would have been made without this service and 79%preferred a management strategy to be included in the report. 90%of patients had been informed of the result by their GP. Conclusions: Open access echocardiography has a diagnostic yield similar to echocardiograms requested on new hospital outpatients in a district general hospital setting. GPs and patients report high levels of satisfaction with this service. Background: Open access echocardiography is widely available to General Practitioners (GP). There is little data comparing the proportion of echocardiographic studies which are abnormal in open access series with that in hospital outpatient practice. This study compares the diagnostic yield from echocardiogram performed indications by open access and hospital out patient requested groups and assesses the attitudes of GPs and patients to open access echocardiography. Methods: The reports of 151 consecutive patients who had open access echocardiograms were analysed using predefined criteria for an abnormal study. The reports of 100 consecutive patients who had a new outpatient requested echocardiograms for similar indications were used as the control group. The attitudes of GPs and patients to the open access service were also assessed. Results: Fifty seven percent of patients in the open access group and 51% in the hospital requested group had abnormal studies (p> 0.05) GPs who responded to the questionnaire thought the report was easy to understand while 69% thought it led to a change in patient management. 74% said a clinic referral would have been made without this service and 79% preferred a management strategy to be included in the report. 90% of patients had been informed of the result by their GP. Conclusions: Open access echocardiography has a diagnostic yield similar to echocardiograms requested on new hospital outpatients in a district general hospital setting. GPs and patients report high levels of satisfaction with this service.