As one of the complications of (IE), embolization has a great impact on the patient’s prognosis. Early identification of patients prone to develop major arterial embolization during hospitalization would reduce morbidity and mortality, and may warrant early surgical intervention.2.Aim of the study: To assess the value of echocardiography in predicting embolic events and in-hospital mortality in patients with definite endocarditis. 3. Methods: The study involved 99 patients with definite IE according to the modified Duke criteria for the diagnosis of IE. Two thirds of the patients were recruited from the prospective IE database of Cairo University Hospitals while one third of the patients were newly admitted. 4.Results: -Embolic events: Embolization occurred in 40.4% of patients during index hospitalization. Female gender was a highly significant risk factor forembolization. Vegetation length was a useful predictor of embolization.A cut-off value of 2.095 cm was most useful in predicting embolization.-Mortality: Atrial fibrillation/flutter was a powerful predictor of mortality ascompared to sinus rhythm. Surgery decreased the risk of mortality, even if PVEwas excluded from the analysis. The presence of heart failure functional classIII/IV or fulminant sepsis necessitating inotropic support were significantpredictors of mortality. The only echocardiographic parameter useful inpredicting embolization was the presence of valvular stenosis. 5.Conclusion: This study clearly shows that female gender is a highly significant risk factor for embolization, and that vegetation length is a useful predictor of embolization in females, but not in males. Vegetation length is a useful predictor of embolization in NVE but not in PVE. Atrial fibrillation/flutter, not having surgery, embolization, heart failure functional class III/IV and fulminant sepsis are all useful predictors of mortality, which allows identification of high-risk patients in whom an aggressive strategy will be potentially useful.