Introduction: Atrial septal aneurysm (ASA) is described as a saccular deformity, generally at the level of the fossa ovale, which protrudes to the right or left atrium or both. This can be associated with acquired and congenital heart diseases or as an isolated pathology. It does not always produce symptoms & are usually diagnosed on a routine echocardiography. Material and Methods: Over one year period we have prospectively studied clinically and echocardiographically in 86 patients with the diagnosis of ASA. All echocardiographies were done by experienced Cardiologist cum echocardiographer with ‘Philips Affinity 70C’ dedicated cardiac echocardiography machine. Results: Among the 86 patients with ASA, 43%(37) patients were male & 57%(49) patients were female, female to male ratio was 1.3:1. Clinical associations includes, Hypertension(HTN) 51%, Coronary Artery Disease (CAD) 25.6%, Cerebrovascular Disease 7%, Arrhythmias 3.5%, Mitral Valve Prolapse 2.3%, Patent Foramen Ovale (PFO) 2.3%, LV Mass 1.2% & normal variants were 7%. Considering types of ASA, type 1R was most common & was 49% & type 5 was least common 4%. Conclusions: This study supports the commonality in identifying ASA by transthoracic echocardiogram. Its definitive association with acquired and congenital heart diseases, but also as an isolated and totally asymptomatic entity. It is more prevalent in female, right atrial bulging types of ASA, and a tendency towards the mobile types of ASA.