In the past 40–50 years, abdominal ultrasound has become the most important tool of imaging for acute and chronic gastroenterologic diseases. There are significant differences in different countries in the use of ultrasound and in the experience with ultrasonography of the gastrointestinal tract, but there is no doubt that ultrasonography in skilled hands (as an easily accessible and rapidly available point-of-care-method) will provide deep and reliable insights into the pathology of the abdomen, including the stomach and the small and large intestines. Often enough, abdominal ultrasonography, together with clinical presentation and laboratory values, will be sufficient to come to a definitive diagnosis and to initiate medical or operative treatment. In many other patients, ultrasonography can be used as the first imaging procedure, which will guide further diagnostic efforts in the correct direction and may determine which further diagnostic modality—upper or lower gastrointestinal endoscopy, CT or MRI scans, laparoscopy, capsule endoscopy, or other endoscopic procedures for the evaluation of the small intestine—is likely to be the most successful in coming to a diagnosis. Furthermore, intestinal ultrasonography is the imaging method of choice to control the response to treatment after a definitive diagnosis.