Contrast enhanced ultrasound has long been in clinical utility for assessing the liver and characterising focal liver lesions. In this context, CEUS is particularly useful in determining whether there are liver metastases and examples of how useful CEUS can be for assessing the liver and indeterminate lesions will be illustrated. However, one innovative use of ultrasound contrast is that they are taken up by the lymphatic system after a subdermal injection and has been used with some success to identify the axillary sentinel lymph node from the breast after a periareolar injection, similar to blue dye. By this method, the node can be percutaneously biopsied under ultrasound guidance and in many cases can help obviate the need for a second operative procedure. Data from four centres performing this technique is highly encouraging where there is a positive predictive value of 92-100% and a negative predictive value for malignant lymph node involvement of 85-90%. The technique will be illustrated in depth and the results and clinical implications discussed where an algorithm to sub-select patients for maximum benefit/ yield of this technique will also be outlined.