The use of ultrasound has moved to centre stage in the management of haemodynamically unstable patient. The ability to apply rapidly, the mobility of devices, and bedside delivery are amongst the advantages in using it. In particular, the widespread application of echocardiography has greatly changed the way in which shocked patients are diagnosed and treated. Most importantly is the ability for the clinician to rapidly identify the type of underlying shock, identify pathophysiology that requires immediate treatment and then to clearly outline the need for further imaging or other diagnostic tests.