The use of ultrasound for the investigation of urgent diagnostic dilemmas is by no means new. Although it has been widely used for almost 40 years, during the past two decades ultrasound has achieved a primary role in the investigation of emergent conditions, notably in the trauma setting. This is further underscored by the American College of Surgeons (ACS) training initiatives. In addition to the basic ultrasound course sponsored by the ACS at the Clinical Congress meetings, the ACS will offer a specialty module course, "Ultrasound in the Acute Setting," that covers ultrasound as used in trauma, critical care, and acute general surgical problems. This initiative underscores the surgeons' interest in having ultrasound as an integral part of their trauma practice. Having the ability to perform and interpret the ultrasound examination gives the surgeon the advantage of obtaining immediate information about the patient. Considering the pace of the trauma setting, ultrasound is an ideal modality for assessment of these patients. It should be the initial diagnostic test for the evaluation of patients with precordial wounds and blunt truncal injuries because it is rapid and accurate, and it augments the surgeon's diagnostic capabilities.