Fracture ultrasound has increasingly come into the focus of international research. A growing number of original articles and a meta-analysis show that wrist fractures can be diagnosed without X-ray in children up to 12 years. Further original publications state that elbow fractures can be ruled out by exclusion of intraarticular effusion and in proximal humerus fractures the number of X-rays is reduced by about 50 %, while the quality of diagnosis is improved. Screening for occult fractures is another good indication. Clavicle fractures, and ac-joint sprains can be diagnosed better with US than with X-rays. A number of research groups have contributed valuable research about the different indications. The aim of this paper is to give an overview of the basics and actual fields of application for fracture ultrasound of the extremities.