The right ventricle can often be neglected during the clinical and echocardiographic assessment of critically unwell patients. Its complex shape and close proximity to other vital structures, makes it vulnerable to injury in many disease states such as pulmonary embolism, cardiomyopathies, valvulopathies and ARDS. The RV is viewed as the "forgotten ventricle" but recognising a struggling RV, should form part of an integrated clinical and echo assessment to drive patient management. A series of case studies will be presented to highlight the pitfalls and challenges in assessing the RV in critical illness.