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Pulmonary hypertension (PH) is an increasingly common condition encountered by physicians and cardiologists. PH is a complex, multidisciplinary disorder characterized by elevated mean pulmonary artery pressures, which can be the hemodynamic and pathological culmination of a large variety of distinct underlying disorders. This makes an accurate etiological diagnosis challenging for the clinician. History and physical examination, although nonspecific, can point toward a particular diagnosis, gauge the severity of PH, and assist in identifying associated disorders. However, a well-performed echocardiographic examination can enable a physician to arrive at an accurate diagnosis. Here, we present an interesting case in which a careful systematic transesophageal echocardiographic assessment allowed us to reach an accurate diagnosis for the etiology of PH.