Abdominal ultrasound examinations are noninvasive and relatively easy to perform. Therefore, they are widely used for voluntary clinical screenings. However, there are no clear regulations or standardized examination criteria for such examinations. To achieve inter-facility standardization, all procedures must be evaluated objectively, following the same guidelines and diagnostic criteria. In 2014, the Manual for Abdominal Ultrasound in Cancer Screening and Health Checkups was created. This is a standardized manual used by the Japan Society of Ultrasonics in Medicine, the Japanese Society of Gastrointestinal Cancer Screening, and the Japan Society of Ningen Dock. In the same year, the National Federation of Industrial Health Organization began a survey on abdominal ultrasound accuracy control. Wide use of the manual will improve testing conditions and help in standardizing criteria, which should enhance the accuracy of abdominal ultrasound screenings. Implementing third-party accuracy control and undergoing objective evaluations will also contribute to enhancing the accuracy of the screenings. This report summarizes the current status of abdominal ultrasound screening and discusses the challenges faced in its standardization.