Epicardial fat is a metabolically active organ that generates various molecules, which could significantly affect cardiac function. Furthermore, epicardial adipose tissue may also reflect intra-abdominal visceral fat. Therefore, the ultrasound assessment of this tissue could serve as a reliable marker of visceral adiposity. Epicardial adipose tissue is also clinically related to anthropometric and clinical parameters of metabolic syndrome, therefore the ultrasound assessment of epicardial fat could be a simple and practical tool for cardiovascular risk stratification in clinical practice.