The male urethra is analyzed separately into two major sections, namely posterior and anterior. Each section addresses specific diseases including traumatic, inflammatory, congenital, and neoplastic disorders. Technic of male ultrasound urethrogram is analyzed in detail discussing advantages and limits compared to radiographic technique. Normal bulbourethral (Cowper) glands are practically invisible at imaging. However, inflammatory or congenital pathologies make visible these small glands or their ducts. Syringocele classification is reported. Female urethral diseases are examined in detail including cancer and diverticular disease. Ultrasound plays a key role in diagnosis, management, and follow-up of urethral diseases growing its relevance in addition to standard radiographic techniques and endoscopic instrumentations.