Ultrasound of the foot and ankle offers low cost, in-office real-time dynamic imaging without radiation. Given the complex and relatively smaller size of the many joints of the foot, ultrasound guidance can increase the accuracy of intra-articular aspirations and injections. Whether helping to establish a diagnosis, aid in nonoperative treatment or localize anatomy for postoperative pain control, ultrasound is an invaluable imaging technique for a foot and ankle surgeon.