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Patent ductus arteriosus is a common congenital heart disease. The disease has varied presentations, ranging from severe respiratory distress and ventilatory requirements in preterm babies to asymptomatic ducts in older children. Echocardiography is the primary tool for diagnosis and assessment of its hemodynamic significance. The decision on the need for and timing of duct closure is made after integrating clinical and echocardiographic findings. Echocardiography is also utilized for planning percutaneous closure where the size and shape of the duct is key. During transcatheter closure, echocardiography helps assess device placement and impingement of nearby structures. This approach makes arterial access dispensable in experienced hands and is particularly helpful in preterm babies and young infants.