The effect of age and gender on left ventricular (LV) size, muscle mass, and systolic function as determined by two-dimensional echocardiography has not yet been investigated in a large population. Normal transthoracic two-dimensional echocardiography studies of 5307 subjects (47% males) performed between March 1990 and December 2011 were analyzed. LV end-diastolic volume index (LVEDVI), LV muscle mass index (LVMMI), LV ejection fraction (LVEF), and LV fractional shortening (LVFS) were compared in different age groups. LVMMI increased in females from 66.4±1.3g/m(2) (7-20years) to 76.3±0.9g/m(2) (60-80years; P<0.0001) and in males from 81.9±1.7g/m(2) (7-20years) to 94.6±1.3g/m(2) (60-80years; P<0.0001). LVEDVI decreased in females from 49.8±0.9mL/m(2) (7-20years) to 42.8±0.6mL/m(2) (60-80years; P<0.0001) and in males from 56.6±0.8mL/m(2) (7-20years) to 49.0±0.7mL/m(2) (60-80years; P<0.0001). A significant increase in LVEF was observed with age (P<0.0001 for both genders), but it was more pronounced in females (62±0.5% [age 7-20years] vs. 65±0.3% [age 60-80years]) than in males (62±0.5% [age 7-20years] vs. 64±0.3% [age 60-80years]). Similarly, LVFS increased in females from 37.7±0.5% (7-20years) to 42.4±0.4% (60-80years; P<0.001) and in males from 37.3±0.5% (7-20years) to 39.4±0.5% (60-80years; P<0.001). LVEF, LVFS, and LVMMI increase with advancing age, in particular in females. In contrast, LVEDVI decreases with age. These findings indicate that the LV undergoes a lifelong remodeling.