Cardiovascular diseases (CVDs) are a major challenge in global health. Despite significant advances in treatment and management, the incidence and mortality rates of CVDs have been rising in recent years, particularly in the United States. With continuous advancements in medical technology, perioperative transesophageal echocardiography (TEE) has become a key technology in cardiac surgery, enhancing surgical success rates and patient safety. The application of TEE spans preoperative planning, intraoperative monitoring, and postoperative evaluation, especially in complex procedures such as mitral valve repair and aortic valve replacement, where it plays an indispensable role. Simultaneously, the introduction of artificial intelligence (AI) brings new prospects for TEE image analysis and diagnostic support, significantly improving diagnostic accuracy and real-time decision-making capabilities. However, the application of TEE technology faces challenges such as high costs, uneven technological diffusion, and the high skill requirements for medical personnel. Therefore, establishing standardized training protocols and strengthening multidisciplinary collaboration are crucial. This paper reviews the application of TEE in cardiac surgery and its path toward educational and practical standardization from a global perspective, emphasizing its importance in improving the postoperative quality of life for patients and exploring future directions in technological innovation and educational optimization.