There are three types of arteriosclerosis (hardening of the arteries): atherosclerosis, Monckeberg's arteriosclerosis, and arteriolosclerosis. The features of central large-vessel atherosclerosis are familiar and frequently depicted at sonography of the carotid arteries and abdominal aorta. Monckeberg's arteriosclerosis is not often encountered during ultrasound examinations. The authors report a case of Monckeberg's arteriosclerosis demonstrated by sonography. Its pathogenesis and distinctive imaging findings are described.