Endorectal (ERUS) and endoanal (EAUS) ultrasound imaging is increasingly being performed by surgeons in the office and outpatient setting for the assessment of both benign and malignant disease. Multiple studies have demonstrated the accuracy of these modalities in identifying pertinent anatomy and anatomic abnormalities. The ultrasound is easily tolerated by most patients, and is easily performed with minimal preparation on the patient's part. The ability of the surgeon to perform and interpret this straight forward diagnostic procedure allows for the simplification of the diagnostic process and a more rapid determination of treatment options for the patient.