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Background: Transcatheter closure of atrial septal defect (ASD) is an alternative approach to surgery in selected patients. Balloon stretched diameter (BSD) is considered as the standard way of measuring ASD size. Three‐dimensional transesophageal echocardiography (3D‐TEE) provides views of the ASD allowing its measurement and identifying its spatial relation with neighboring structures. Our aim was to compare the BSD and 3D‐TEE methods to measure the ASD size before transcatheter closure. Methods and Results: Seventy‐six consecutive patients were enrolled for ASD device closure. Three‐dimensional transesophageal echocardiography and balloon sizing were adequately performed in 70 patients before the defect closure. The mean maximal diameter measured by 3D‐TEE was 20 ± 15 mm (range 10–28) while the mean BSD was 22 ± 4.8 mm (range 9–31). When comparing the 3D‐TEE and …