Transabdominal urological sonography covers the organs kidney and urinary bladder as well as the retroperitoneal space. As a rapid and side-effect-free point-of-care diagnostic technique, it is used in a variety of ways in the majority of patient contacts. Numerous scientific data underscore the special value of ultrasound in the primary diagnosis of almost any pathology regarding the kidney or urinary tract: In cases of urothelial or renal carcinoma, urolithiasis and urinary flow disorders, ultrasound exams are performed before more invasive or complex diagnostics are indicated. Innovative techniques, in particular contrast-enhanced ultrasound, provide a glimpse of future possibilities and make it likely that the importance of sonography in urology will continue to increase. Appropriate education and training of all practicing urologists is therefore just as indispensable as documentation and archiving of image data.