Transperineal ultrasonography (TPUS) is a versatile diagnostic tool in urogynecological outpatient practices. It provides rich information that helps us understand the structural and functional integrity of the pelvic floor and the lower urinary tract. TPUS is subdivided into two classes: translabial ultrasonography (TLUS) and introital ultrasonography (IUS). TLUS is used to detect sites of mechanical failure within the pelvic floor. This procedure is usually performed in the context of dynamic ultrasonography, by normal convex probe adequately covered, with squeezing, coughing, and straining efforts that the subject addresses to the pelvic floor. The subject is normally placed in the gynecologic position during this procedure, but an examination in a semi-crouching position may reveal another pelvic floor weakness that has been masked while the subject was placed horizontally. IUS is an emerging method of examination to detect acoustic alterations in the pelvic floor, by breaking down three-dimensional high-resolution ultrasonographic data. Many of the obstetric injuries in the perineum, in the anus, and in the pelvic diaphragm are visualized by this technique. TPUS helps screen the cases that may benefit from surgical treatment. If this procedure is put in practical use widely by gynecological and urological outpatient clinics, it will enable them to determine which cases should be referred to which advanced medical facilities. TPUS may assume a substantial role in reassigning the tasks in the field of urogynecology, forging a new relationship between clinics and hospitals.