Pelvic floor architectural defects are related to parity, aging, hysterectomy, and chronic straining. The muscles and the supportive connective tissue can be torn, stretched, or denervated. A basic understanding of pelvic floor anatomy is essential to understanding 2D, 3D, and 4D anatomy as visualized by pelvic floor ultrasonography. The current chapter aims to use the suspension bridge analogy and simple representative drawings to communicate complex pelvic floor anatomy and function to readers.