The interaction between the left ventricle (LV) and the arterial system, (ventricular–arterial coupling, V-AC) is a key determinant of cardiovascular function. V-AC is most frequently assessed in the pressure–volume plane using the ratio of effective arterial elastance (Ea) to left ventricular (LV) end-systolic elastance (Ees). Ea (a composite index of arterial load) is computed as end-systolic pressure/stroke volume, whereas Ees (a load-independent measure of LV chamber performance) is ideally assessed invasively using data from a family of pressure-volume loops obtained during an acute preload alteration. Single-beat methods have also been proposed, allowing for non-invasive estimations of Ees using simple echocardiographic measurements. The Ea/Ees ratio is very useful because it provides information regarding operating energetic and mechanical efficiency of the ventricular-arterial system. However, it should be recognized that V-AC encompasses many different physiologic aspects, many of which are not captured in the pressure-volume plane. Therefore, additional assessments can provide important incremental physiologic information about the cardiovascular system and should be more widely used. In particular, it should be recognized that: (1) Comprehensive analyses of arterial load are important because Ea incompletely characterizes (and does not depend exclusively on) arterial properties; (2) The myocardial (systolic) loading sequence is important for V-AC and can profoundly impact LV function, remodeling and progression to heart failure; (3) LV time-varying LV elastance does not equal time-varying myocardial wall stress, which better addresses the myocardial loading sequence; (4) When a stenotic aortic valve is present, special considerations are required to assess V-AC and the combined valvular-arterial load.