ObjectivesAlthough ultrasound (US) is considered one of the safest imaging modalities, concerns have been raised regarding potential infection transmission risks through US procedures. A survey was undertaken by the European Society of Radiology (ESR) to establish infection prevention and control measures in US and to highlight the importance of good medical practice.MethodsAn online survey was sent to all 22,000 full ESR members.ResultsThe response rate of completed surveys was 4.3 % (946 practitioners, 97 % of which were radiologists, mostly working in larger hospital settings). Among respondents, 29 %, 11 % and 6 % did not disinfect the US probe after every patient when performing standard surface US, endo-cavity US and interventional procedures, respectively. Eleven percent did not always use probe covers for endo-cavity US; for interventional procedures, the proportion was 23 %. A minority used sterile gel sachets in direct patient contact for endo-cavity scans (30 %), and 77.5 % used sterile gel for interventional procedures.ConclusionsThe survey results highlight a wide range of practices throughout Europe and the need to raise awareness amongst practitioners regarding the importance of infection prevention and control measures. The development of European recommendations encompassing all US examinations, together with education is a priority.Main Messages• Transmission of infection through ultrasound procedures is possible.• There is a wide range of ultrasound probe decontamination practices in Europe.• Not all practitioners use probe covers for endo-cavity or interventional ultrasound.• Not all practitioners use sterile gel for internal and invasive procedures.• Currently there are no European recommendations encompassing all US examinations.Electronic supplementary materialThe online version of this article (doi:10.1007/s13244-016-0528-z) contains supplementary material, which is available to authorized users.