Ultrasound (US) evaluation is the first-line imaging modality in the evaluation of women with gynecologic problems. US evaluation can be performed using a transabdominal or transvaginal approach. The familiarity with normal anatomy and normal variants depicted by transabdominal or transvaginal US is the key to make reliable detection and interpretation of the pathologic processes affecting female pelvic organs. In this chapter, we review the technique of US evaluation, the normal US anatomy, and the normal variants of the pelvic organs. Pseudolesions that may lead to false positive diagnoses are also discussed and illustrated.