The presence of operational and organizational differences in the use of ultrasonography in Italian nephrology units has prompted this survey on a nationwide scale. The survey was carried out by questionnaire and included questions about the activity and equipment of each nephrology unit, dedicated personnel and relevant training, and the fields of ultrasonography application. Seventy-five percent of the contacted care units replied to the questionnaire. Twenty-six percent of these performed their ultrasound examinations outside the care unit, sharing equipment with other units. The mean lifetime of ultrasound devices was longer (5.8 years) than allowed by the electro-medical equipment regulations. In spite of an increasing number of nephrologists with ultrasonographic expertise, in each care unit the percentage of physicians performing ultrasound examinations was very low. The number of operators who learned this methodology directly at surgeries using ultrasound devices was higher than that of operators who attended training courses and obtained the relevant certificates. In addition to the kidneys and urinary tract, other body districts investigated included abdominal organs, parathyroids, vascular access for hemodialysis treatment, and the bone-joint system. Moreover, ultrasonography was widely used for surgical procedures in nephrology. However, in spite of the widespread application of ultrasound imaging, the use of radiology was unexpectedly high (80%). Finally, the questionnaire results evidenced the particular care of nephrologists towards follow-up for situations of nephrological interest, such as acquired renal cysts, vascular access visualization, and monitoring of parathyroids.