Shortly before Dreiländertreffen 2008, the Leipzig group would like to review "Dreiländertreffen plus". The term "plus" is used because the 31(st) Dreiländertreffen was held together with the EFSUMB. What did this achieve? What does this mean for us in Davos? Review and evaluation of the contributions indicate a valuable enrichment due to the international participation but show a continued significant lack of large prospective studies to validate the clinical value of sonography. This issue cannot be corrected by efforts of the ultrasound associations to provide excellent and efficient advanced training at the Dreiländertreffen. The most important and striking contributions relate to contrast agent sonography and in particular to the differential diagnosis possibilities for liver tumors (DEGUM multicenter study), monitoring after interventional stent implantation for aortic aneurysms, and the monitoring of angiogenesis inhibition in the treatment of malignant tumors. Since these contributions are highly relevant and have the potential to be applied to guidelines, they require further scientific review and publication. The presidents of the three ultrasound associations in personal union with the presidents of the Dreiländertreffen should therefore place more importance on the scientific component of the Dreiländertreffen since the three countries are currently weak in this regard. Ultrasound diagnostics could play an important role in clinical health care research given the current exaggerated economic considerations in medicine. In addition, scientific work provides the basis for the future of the associations.