This article discusses current understanding of the anatomy, pathophysiology and echocardiographic characteristics of false tendons. False tendons can be found in about half of the surveyed people’s hearts at autopsy. Despite the fact that it took more than 100 years since their first description, the functional significance of these structures remains largely unexplored. It has been suggested that they may inhibit left ventricular remodeling. Some studies have shown that false tendons may reduce severity of the functional mitral regurgitation. False tendons can promote subaortic stenosis and may constitute a morphological substrate of the arrhythmias.