Pelvic pain is a common symptom experienced by women during their lifetime. Accurate diagnosis can be difficult due to mimics of gynecological pathology that span gastrointestinal and urologic etiologies. Ultrasound is a rapid, cost-effective, accurate, and potentially life-saving imaging modality that is easy for clinicians to utilize at the bedside. This chapter will cover ultrasound indications, techniques, and criteria for diagnosing gynecological conditions, including Müllerian duct anomalies, uterine fibroids, pelvic congestion syndrome, endometriosis, ovarian cysts and torsion, other ovarian masses, and pelvic inflammatory disease.