Infective endocarditis (IE) is a severe, life-threatening disease of the endocardial surface, most often caused by bacterial infection. Despite advances in diagnostic and therapeutic strategies, IE continues to be associated with high morbidity and mortality, largely due to its heterogeneous clinical presentation and the destructive cardiac complications it may cause. Echocardiography, whether transthoracic (TTE) or transesophageal (TEE), remains the cornerstone imaging modality for diagnosis, guiding therapeutic decisions, and monitoring disease progression. It is particularly crucial for the detection of perivalvular and valvular complications, which significantly influence prognosis. In this context, we conducted a clinical study at the University Hospital Souss Massa in Agadir. The primary objective of this study was to characterize the echocardiographic perivalvular involvement in infective endocarditis, with particular emphasis on the frequency of destructive complications—including abscesses, pseudoaneurysms, new partial prosthetic valve dehiscence, and fistulas—and to assess their detection using transthoracic (TTE) and transesophageal echocardiography (TEE). Secondary objectives included comparing our local data with those in the international literature, in order to place our experience in the global context and draw clinical implications.