Abdominal ultrasonography is an essential tool for physicians. In contrast to other imaging methods, ultrasound examination is a cost-effective real-time imaging method without radiation effects. As in all other imaging methods, abdominal ultrasound requires an experienced examiner and high quality equipment to maintain a high quality. Abdominal ultrasonography is at least equal to cross-sectional imaging methods in most clinical issues, e.g., in inflammatory bowel disease, vascular liver diseases, or real-time surveillance of interventions. The range of applications for ultrasound has been markedly expanded by using contrast-enhanced ultrasound to detect and characterize space occupying lesions or perfusion aberrations in- and outside the liver.Ultrasound-guided fine needle aspiration biopsy or drainage of space occupying lesions and pathological liquids are minimally invasive standard ultrasound-guided interventions. Ultrasound-based tumor therapy as well as sclerotherapy of symptomatic nonparasitic cysts of the liver, kidneys, or spleen are also performed. By being able to provide quantitatively reproducible measurement of tissue stiffness, ultrasonography has entered a new era. The development of mechanical elastography also promises a new form of tissue characterization.