Background: Masses are common findings in echocardiography and cardiac imaging; largely confusing without surgical and pathological interventions for diagnosis. Method: Through case presentations and peer-reviewed publications, this paper elucidates a scientific methodology on how a clinician can arrive at a timely diagnosis by focusing on the respective properties of the mass on imaging. Results: Twenty-three cardiac masses and two imaging cases are delineated respectively to tumor, vegetation or emboli, as well as other findings. One of the masses is substantiated by histopathological analysis after additional assessment with transesophageal echocardiogram. Conclusion: With eminent symptoms and potentially perilous delay of treatment, a careful examination of cardiac masses provides numerous unique clues in helping the clinician expedite treatment.