This review aims to provide an update of the currently available data regarding ultrasound (US) imaging in crystal-related arthropathies (CA). US imaging allows the assessment of patients with CA showing synovitis, bone erosions, tendon, bursal and cartilage pathology. Moreover, the conformation and anatomical location of crystals may help distinguish the different clinical entities, improving the accuracy of diagnosis and sensitivity of disease activity and therapy monitoring. Future topics for study include: consensus on scanning protocols and scoring systems, evaluation of greyscale and power Doppler US in the therapy monitoring of gout and evaluation of the role of 3D US in CA.