Point of care clinical ultrasonography is used across multiple medical specialties to guide diagnosis and treatment and to enhance the safety of invasive procedures.In allergy and immunology, point-of-care ultrasonography is underused.The standard epinephrine autoinjector (EAI) needle length may be inadequate for intramuscular delivery of epinephrine, particularly for women at risk of anaphylaxis. Ultrasonography can identify the need for longer EAI needle lengths to compensate for increased skin to muscle depth attributable to increased subcutaneous tissue in this patient population.Conversely, for pediatric patients, the lengths of commercially available EAIs lengths may be too long, risking inadvertent intraosseous injection and resultant complications. Ultrasonography can evaluate skin to bone depth in these patients, which may require adjustment to epinephrine administration.Point-of-care ultrasonography can also be used in needle guidance for subcutaneous allergen immunotherapy injections to reduce the chance of inadvertent intramuscular injection and systemic adverse effects.