This article reviews the emerging role of sonography in the initial assessm
ent of blunt abdominal trauma. Popular in Europe for over 2 decades, severa
l major trauma centers in North America now consider sonography to be the s
creening modality of choice for the rapid detection of hemoperitoneum follo
wing blunt trauma. As a fast, portable, and noninvasive modality, it has ad
vantages over both diagnostic peritoneal lavage and CT. This article presen
ts the various appearances of hemoperitoneum, parenchymal injury, and poten
tial pitfalls and limitations.