The article reports on 150 patients, 86 men and 64 women, aged between 16 and 90 years, who were subjected to sonographic examination directly after they had been admitted as emergency cases. In the group of patients under examination, the clinical disease pattern of acute upper abdominal complaints ranked first, followed (in the rate of incidence) by abdominal trauma and acute metabolic disease. In more than 25 % of the cases the decisive diagnosis was made on the basis of sonography only, so that there was no delay in deciding whether treatment should be initiated or whether the diagnosis required further differentiation. In another over 20 % of the cases ultrasound diagnosis contributed quite substantially towards arriving at the final diagnosis. The number of failures or unsuccessful examinations was about 2 % in each group. The rapid, mobile and risk-free use of sonography is emphasised. The results allow the conclusion that the share of ultrasound in the diagnosis of acutely and severely diseased patients should be increased and that sonography should in fact be placed first and foremost, as far as possible, among the diagnostic tools.