Recent evidence has suggested certain advantages of the intraoperative use of ultrasonography (US) for urology. Advances in US technology include availability of compact, specially-formed US probes (i.e. endoluminal, laparoscopic, transrectal, and transvaginal) and new US functions (such as Doppler, harmonic, 3D, virtual sonography, 4D, contrast-enhanced, elastography, the fusion system with computed tomography/magnetic resonance imaging, and augmented reality). These have the potential to enhance visualization of the surgical anatomy, even beyond the surgical view, and thus increase the precision of surgery. US has been demonstrated to be the most widely-used intraoperative imaging, with the advantages of its real-time nature, non-invasiveness and easy-handling. Importantly, it can be performed by urologists, who in contemporary practice are going to need increasing familiarity with intraoperative imaging. This review article focused on US intervention and intraoperative US, and current data were summarized regarding the advantages, limitations, and future potential of US technology in the modern era of minimally-invasive urology.