Abstract: AIM: To investigate the value of echocardiography in closing perimembranous ventricular septal defect (PmVSD) with narrow-waist occluder. METHODS: Forty three patients were examined by PHILIPS Sonos 5500 color Doppler imaging system with 2-4 MHz transducer, including measuring and monitoring before, during, and immediately after closing and during follow-up. RESULTS: Size of the left side of the VSD measured by echocardiography was larger than the right side. Most right-side VSD defects were visualized as multiholes or multishunts. VSD shapes were irregular or neoplastic. No significant difference was found between measurements of cardiovascular angiography and echocardiography. The size of the occluder was 4-14 (7.7±2.5) mm. All cases were successfully occluded except one case with trivial residual shunt, which disappeared after 3 days. Short-term follow-up was conducted in the three cases with trivial tricuspid valve regurgitations and no abnormality was observed. CONCLUSION: PmVSDs have different shapes with significant differences. Echocardiography can be used to obtain satisfactory curative effects in occluding PmVSD with narrow-waist occluder.