Since a number of imaging approaches are used to measure left atrial volume, it is important to know whether values obtained by different imaging modalities or by the same imaging modality using different measurement algorithms are interchangeable. This is particularly relevant for follow-up examinations. The advent of real-time full-volume three-dimensional echocardiography allows rapid measurement of chamber volume without making geometric assumptions. Furthermore, the semiautomatic methods allow repeat measurement of volume changes during the cardiac cycle thus permitting volumetric quantification of atrial function. Although three-dimensional imaging modalities including magnetic resonance imaging and computed tomography are considered as non-invasive reference methods for cardiac chamber volume determination they are less available, more costly, more time consuming and have other specific limitations, and therefore are less suitable for atrial volume and function measurement in daily clinical practice. In this article we provide a critical review of available literature validating and comparing different non-invasive three-dimensional imaging modalities and measurement algorithms used for determination of left atrial volumes with special reference to three- dimensional echocardiography.