Bowel ultrasound is a powerful clinical problem-solving tool. In patients with lower abdominal pain, bowel ultrasound can help determine whether the cause of pain is urological, gynaecological or intestinal in origin. The presence of bowel wall thickening, surrounding inflammatory changes (creeping fat), associated lymphadenitis and free fluid are all features of bowel inflammation and can be seen both in inflammatory bowel disease (IBD) and infection. In patients with Crohnís disease, bowel ultrasound can also demonstrate loss of wall stratification signaling the presence of transmural ulcers as well as other complications such as fistula tracks and collections. There are numerous other specific applications of bowel ultrasound in different patient groups including pre-term neonates (assessment for necrotising enterocolitis, bowel obstruction), children (intussusception, appendicitis, bowel obstruction), adults (IBD, appendicitis, infection, diverticular disease, obstruction), patients with known IBD (disease activity monitoring, fistulating disease, collections) and others. It is essential that all practitioners of general abdominal ultrasound gain familiarity with the basics of bowel ultrasound in order to adequately assess patients with abdominal pain. In countries where non-clinician sonographers are performing diagnostic ultrasound (UK, USA, Australia and New Zealand), it is particularly important that patients with lower abdominal pain do not get ìprotocolledî into either upper abdominal or gynaecological ultrasound because protocol-based approaches may restrict the scope of examination resulting in bowel pathology being inadvertently skipped. Instead, sonographers should always perform clinically-focused ultrasound examination that specifically addresses the cause of pain and includes bowel survey in all patients with lower abdominal pain. In this presentation, we will look at a wide variety of bowel pathologies using high-resolution video clips.