With further development of transcatheter techniques and improved occlusion devices, percutaneous closure has become the treatment of choice for secundum ASD. The Amplatzer septal occluder device is frequently used for ASD occlusion due to its straightforward implant technique and efficacy in occluding a wide range of ASD sizes. TEE is vital in the recognition of morphologic variations of the ASD and patient selection. It allows clear visualization of the defect and the device during the procedure, precise measurements of stretch diameters, guiding of deployment, and stable positioning of the device. This is especially important in patients with large ASDs or multiple ASDs and those with atrial septal aneurysm. With TEE, incorrect positioning of the device can be detected while it is still screwed to the delivery cable, which allows its early redeployment, before any complications occur. Compared with the patients undertaken surgical repair, the left ventricular function using strain rate imaging was preserved after the device closure. Echocardiographic evaluation for ASD device closure is essential in patient selection, during procedure, after occlusion, and long term follow-up.