Pulled elbow is a disorder commonly observed in children in routine medical practice, Pulled elbow or nursemaid's elbow is a radial head subluxation caused by a sudden pull on the extended pronated forearm.; however, when the circumstances involved in the injury are unknown, difficulty has been encountered in differential diagnosis whether it is a bone fracture or pulled elbow. One of the reasons involved has been the unavailability of diagnostic imaging in confirming the diagnosis of the pulled elbow. Nursemaid's elbowsare indistinguishable from healthy elbows on radiograph. This article reviews the key issues to be considered while assessing these patients with real time musculoskeletal ultrasonography.