Assessment of myocardial contractile function during exercise is important in gaining an understanding of the normal mechanics of the cardiovascular responses to exercise stress. Such insights are important in identifying determinants of cardiovascular fitness in athletes as well as assessing patients with heart disease. While obtaining such measurements in the past has been challenging, recent echocardiographic developments offer promise of providing new insights into the nature and magnitude of inotropic changes during exercise. This review provides a state-of-the-art overview of these technologies in light of the current understanding of the role of myocardial contractile function in response to a bout of progressive dynamic exercise.