With the advent of high resolution probe and state of Art machine the scope of ultrasound has further expanded and is frequently used in acute emergencies. Good Sonologist in ER attending a patient can easily separate acute Medical Emergencies with cases requiring immediate surgery. Other tests like laboratory investigation & Radiological exam can supplement to the diagnosis. Color Doppler ultrasound should always be used with B-Mode in order to separate vascular from non-vascular masses. Ultrasound is a useful diagnostic tool in assessing Fluid, Hematoma, Inflammation, Tumors, Torsion and Vascular problems. Any patient coming in the Emergency room with history of trauma, Abdominal distension, Pain and swelling one should think of Ultrasound first. My paper will highlight the application of ultrasound in Neck, Chest, Body, Small Parts, Limbs & OB/GYN related acute problems which require urgent attention. Sonographic images of various cases will be shown and its importance highlighted.