Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in sonography and it is being increasingly used for the evaluation of focal liver lesions (FLLs). The unique feature of CEUS of non-invasively assessing in real-time liver perfusion throughout the vascular phase has led to a dramatic improvement in diagnostic accuracy of US in either detection or characterization of FLLs, as well as in the guidance and evaluation of response of therapeutic procedures. Currently, CEUS is included as a part of the suggested diagnostic work-up of FLLs, resulting in a better patient management and cost-effective therapy delivering. After a brief description of the basis of different CEUS techniques, contrast-enhancement patterns of different types of benign and malignant FLLs, among hepatic pseudolesions, will be described and discussed on the basis of our experience and literature data. At the same time, the most recent concepts and the use of CEUS in different clinical settings will be presented.