Objective: To evaluate the accuracy rate of transthoracic echocardiography (TTE) conducted by respiratory physicians in diagnosing cardiovascular diseases of critically ill patients and analyze the associated causes of operation failure. Methods: We introduced a 2-week of comprehensively onsite TTE study under the guidance of echocardiographers on the basis of being familiar with the associated theory and normal echocardiography imaging. A total of 106 critically ill patients who hospitalized in our department were enrolled in this study. The parasternal long axis view, parasternal short axis view, apical four chamber view, subcostal four-chamber view, and the subcostal inferior vena cava view were performed by one specific physician. All of the information obtained from the five views were recorded and compared to formal echocardiography. Results: The bedside TTE was successfully performed by respiratory physicians in 94 cases. The operation time was (10.5±4.2) minutes and 42% patients showed two more abnormal TTE imagings. The accuracy rate of diagnosis in pericardial effusion, ventrical dilation, elevated tricuspid regurgitation pressure gradient value, and the abnormal inferior vena cava were all 100%. The accuracy rate of valvular regurgitation, regional ventricular wall motion abnormities, reduction of left ventricular systolic function, and septal dyskinesia were 92.6%, 95.7%, 96.8%, and 96.8% respectively. The reasons for the twelve patients with failed operation was recognized as follows: invasive mechanical ventilation (MV) in two cases, cutaneous dropsy in four cases, pneumothorax combined with invasive MV in three cases, simple pneumothorax, thoracocyllosis and positioning limitations in one case respectively. Conclusion: Respiratory physician could accomplish the TTE systematically through short-term learning and give the reliable interpretation for interested views which would be beneficial for clinical diagnosis and treatment in emergency conditions. Invasive MV, cutaneous dropsy, and pneumothorax were considered as the main reasons for operation failure in respiratory department. Furthermore, this study demonstrated a possibly new thought of TTE study for clinicians.