Duplex ultrasonography has gained enormous importance in the vascular practice over the last decade. Technological development with the colour application as well as the high resolution imaging have altered the diagnostic approach, treatment and follow-up of the vascular patients. Research on the epidemiology and natural history of atherosclerosis and thrombosis has also been founded based on the ultrasonic applications, improving our understanding in the pathophysiology of the vascular disease. This article presents an overview of the revolutionary role of the ultrasonic investigations in the arterial and venous disease and outlines the possible limitations of the technique. Financial aspects of its use in the health care system and potential advents in the near future are also discussed.