We report our experience in visualizing the internal mammary artery (IMA) with new enhanced Doppler technology. Twenty-three patients without previous coronary artery bypass grafting formed the study group. Bilateral transthoracic two-dimensional and color flow Doppler IMA images were acquired from multiple intercostal spaces with a prototype ultrasound machine equipped with coherent beam formation technology. In all patients, the IMA was followed from its origin for an average of 15 cm. To our knowledge, a high rate of direct visualization (100%) of the IMA has not been reported previously. Noninvasive ultrasound assessment of the IMA may reduce the need for invasive preoperative testing for patency and length and allow postoperative assessment of coronary artery flow reserve.