Echocardiography is considered as the first as well as the most important diagnostic approach to identify patients living with cardiac amyloidosis (CA). It is still not clear the evolution process of echocardiography during the development of CA, leaving it extremely difficult for clinicians to recognize patients who are suspected of CA at an early stage. Here, we report a patient in his seventies diagnosed with lymphoma-associated AL amyloidosis. The sequence of abnormal changes in echocardiography included decreased left ventricular diastolic function, pericardial effusion, left atrium expansion, ventricular septal thickening, left ventricular posterior wall thickening, right atrium expansion, and decreased cardiac function. A decrease in left ventricular diastolic function and pericardial effusion occurred 3 months prior to a thickening in interventricular septum. Once suspected, 2D-STE examination is highly recommended in the early diagnosis of CA.