With, Sonography, celebrating its 10th birthday, it is timely to reflect on the changes in ultrasound and the role of the sonographer, across the same period. This paper will present the significant changes that have occurred across the last 10 years in a large public hospital network in Australia across a diversity of themes. In the areas where challenges have emerged, the way these were navigated will be described. Documenting this change in ultrasound provision may be valuable to future planning for all key stakeholders.