Abstract. BACKGROUND: Internationally, neonatologists are increasingly performing functional echocardiography to evaluate the hemodynamic status and cardiac function in neonates. The purpose of this study was to describe the current prevalence of and attitudes toward the use and training of neonatologists in functional echocardiography in the United States. METHODS: An anonymous survey was sent to United States neonatal intensive care unit medical directors. Neonatologists scored availability of echocardiography and attitudes toward the use and training of neonatologists in functional echocardiography. RESULTS: Response rate was 43.7% (247 of 565 surveys sent) and captured 95% of the neonatal-perinatal training programs. Nine percent of units had a functional echocardiography trained neonatologist; eight percent of the neonatal-perinatal training programs offered functional echocardiography training. There was no difference in the timely ability to obtain hemodynamic status with echocardiography in units compared by the presence of functional echocardiography trained neonatologists (mean = 3.13 vs. 2.67, p = 0.08) and fellowships (mean = 2.69 vs. 2.72, p = 0.85). Overall positive attitudes (mean = 14.6 ± 3.46) towards the training of neonatologists in functional echocardiography did not correlate with the perceived timely availability of echocardiography support (mean = 2.72 ± 1.43, r = −0.11, p = 0.1). CONCLUSION: Functional echocardiography use and training is not prevalent in the United States. There are positive attitudes toward the training of neonatologists in functional echocardiography that are independent of the presence of fellowships, neonatologists with echocardiography training, and the perceived availability of echocardiography support.