The use of mechanical circulatory support for pulmonary, cardiac, or cardiopulmonary failure is increasing rapidly but requires complex management and continued assessment for proper functioning. Ultrasound is particularly useful to directly visualize the continued proper placement and functioning of a variety of devices designed for respiratory support, right ventricular support, left ventricular support, or combinations of all three. It is also useful to assess recovery and diagnose common complications such as chugging, clot, and bleeding. Bedside evaluations by critical care providers allow for more frequent evaluations and dynamic management hopefully avoiding complications and reducing resource utilization and more invasive imaging.