Aims: Reporting of head and neck ultrasound (HNU) has been outlined to be a major obstacle during ultrasound training due to a lack of standardized structure, content and terminology. Consequently, overall report quality differs significantly between various examiners posing a severe risk factor for information loss and miscommunication. Therefore, the present study’s purpose is to compare the overall quality of free text reports (FTR) and structured reports (SR) of HNU at various stages of training in order to determine the optimal educational level to implement SR.Material and methods: Typical pathologies in HNU were reported upon using SR and FTR by medical students, junior residents and senior residents. The reports were assessed for overall quality, time efficiency and readability. Additionally, user satisfaction was determined using a questionnaire.Results: SRs exhibited a significantly superior report quality (93.1% vs. 45.6%, p<0.001) at all training levels. Overall time efficiency was significantly better for SRs, especially at the stages of medical school and early residency (89.4 s vs. 160.2 s., p<0.001). Using structured reporting also increased user satisfaction significantly (VAS 8.6 vs. 3.9, p<0.001).Conclusions: Implementing structured reporting of HNU results in a superior report quality at all training stages. Greatest benefits for time efficiency are achieved by implementation during medical school. Therefore, structured reporting of HNU should be implemented early on in the training of HNU.