The elbow, a complex hinge joint, plays a crucial role in upper limb function by facilitating flexion, extension, and rotational movements. Due to its intricate biomechanics and vulnerability to musculoskeletal disorders, ultrasound has become an essential imaging technique for evaluating elbow anatomy, diagnosing soft tissue injuries, and guiding interventions. This chapter delves into the sonographic assessment of the elbow joint, focusing on its three primary articulations: the humeroulnar, humeroradial, and proximal radioulnar joints. Moreover, it elucidates the ligamentous structures, such as the ulnar and radial collateral ligaments and the annular ligament, which are vital for joint stability. The muscular and tendinous structures surrounding the elbow, including the flexor-pronator and extensor-supinator groups, are also examined for common pathologies like epicondylitis and tendinopathy. Ultrasound-guided interventions have transformed the management of elbow pain and dysfunction, providing precision for therapeutic injections. This chapter offers detailed instructions on performing ultrasound-guided injections for lateral epicondylitis (tennis elbow) and medial epicondylitis (golfer’s elbow), focusing on pathological tendon changes treated with corticosteroids, platelet-rich plasma (PRP), or other regenerative therapies. Additionally, the chapter discusses the role of ultrasound in guiding botulinum toxin injections for spasticity and dystonia impacting elbow-related muscles, thereby enhancing treatment efficacy and minimizing complications. Musculoskeletal ultrasound permits dynamic, high-resolution evaluations of these structures, enabling early diagnosis and intervention for conditions such as ligament injuries, tendon degeneration, and nerve entrapments. This chapter presents a comprehensive approach to elbow ultrasound imaging, emphasizing both diagnostic applications and interventional techniques to optimize patient care.