Abnormalities of the abdominal aorta and the visceral vessels can represent a diagnostic challenge in patients with both acute and chronic clinical symptoms. In addition to the primary conventional examination using color-coded duplex ultrasound, contrast-enhanced ultrasound (CEUS) with low mechanical index (low MI) may contribute to achieving a precise diagnosis. CEUS is a new and promising method in the diagnosis and follow-up of aortic and visceral artery lesions. Color-coded duplex ultrasound and CEUS with SonoVue(R) allow a rapid and non-invasive diagnosis especially in critically ill patients as these methods can readily be applied at the bedside. In this article the contribution of color-coded duplex ultrasound and CEUS as compared to multi-slice computed tomography angiography (MS-CTA) in various pathologies of the abdominal aorta and the visceral arteries will be addressed.