Ionic liquids, as reaction media, and sonochemistry are two recently developing fields of chemistry that present some similarities. Firstly, they constitute separately unconventional approaches to reaction chemistry that, in many cases, generate improvements in yield, rate and selectivity compared to classical chemistry, or even change the mechanisms or products expected. In addition, both are often associated with green chemistry concepts as a result of their properties and their possible eco-friendly uses. A recent trend has been to combine these two technologies in a range of different applications and the results demonstrate very significant and occasionally surprising synergetic effects. Here we critically review the advantages and limitations of the ionic liquid/ultrasound combination in different applications in chemistry, to understand how, and in which respects, it could become an essential tool of sustainable chemistry in the future. Many practical and theoretical aspects associated with this combination of techniques are not understood or resolved and we discus where fundamental studies might further advance this field.