Breast ultrasound is an important tool in the armamentarium of the breast radiologist. It is an easily available, low cost, radiation free, dynamic modality that can be used in isolation or as a complementary imaging technique to mammography and breast MRI. Due to its operator dependability, it is of utmost importance to have a thorough knowledge of the scanning and image optimization techniques. It scores over the other modalities in providing real time guidance for biopsy and preoperative localization procedures, which are also relatively comfortable to the patient, compared to stereotactic or MRI-guided options.