Background <p>Point-of-care ultrasonography (POCUS) is increasingly recognized as an essential bedside clinical skill and a valuable educational tool in undergraduate medical education. Although many medical schools worldwide have begun integrating POCUS into their curricula, the extent to which undergraduate POCUS education has been formally implemented and accredited in Japan remains unclear. Therefore, this study aimed to investigate the accreditation status and implementation of undergraduate POCUS curricula across Japanese medical schools.</p> Methods <p>We conducted a nationwide, cross-sectional, web-based survey of all 82 Japanese medical schools between July and September 2025. The questionnaire addressed institutional characteristics, perceived educational need for POCUS, accreditation status of undergraduate POCUS curricula, curriculum structure and content, instructional methods, assessment strategies, and perceived barriers and facilitators to implementation. Descriptive statistics were used to summarize findings, and reported barriers to implementation were compared between institutions with and without accredited curricula.</p> Results <p>Sixty valid responses were analyzed (response rate: 73.2%). Although 81.6% of respondents agreed that POCUS should be integrated into undergraduate medical education, only 12 institutions (20.0%) had a formally accredited POCUS curriculum. Among accredited programs, 58.3% implemented longitudinal curricula spanning multiple academic years, most commonly integrating POCUS into clinical clerkships and physical examination teaching. All programs included diagnostic POCUS, with abdominal applications being the most frequently taught, whereas procedural POCUS was included in fewer than half of programs. Post-training assessments were conducted in 58.3% of institutions, primarily through practical skill evaluations. Major barriers to implementation included shortages of trained faculty (75.0%), limited equipment and educational resources (66.7%), lack of institutional leadership to drive curriculum development (58.3%), and insufficient curricular time. No statistically significant differences in perceived barriers were observed between institutions with and without accredited curricula (χ² test, all <i>p</i> values &gt; 0.05).</p> Conclusions <p>Despite broad recognition of the educational value of POCUS, formal accreditation and educational infrastructure remain limited in Japanese medical schools. Institutions that have adopted POCUS commonly employ longitudinal and clinically integrated approaches. These findings highlight a substantial gap between perceived educational need and practical implementation and provide actionable insights for educators and curriculum leaders to prioritize faculty development, resource allocation, and institutional support for undergraduate POCUS education.</p>