Ultrasonic (cavitation) melt processing attracts considerable interest from both academic and industrial communities as a promising route to provide clean, environment friendly and energy efficient solutions for some of the core issues of the metal casting industry, such as improving melt quality and providing structure refinement. In the last 5 years, the authors undertook an extensive research programme into fundamental mechanisms of cavitation melt processing using state-of-the-art and unique facilities and methodologies. This overview summarises the recent results on the evaluation of acoustic pressure and melt flows in the treated melt, direct observations and quantitative analysis of cavitation in liquid aluminium alloys, in-situ and ex-situ studies of the nucleation, growth and fragmentation of intermetallics, and de-agglomeration of particles. These results provide valuable new insights and knowledge that are essential for upscaling ultrasonic melt processing to industrial level.