In the last 20 years ultrasonography has played an increasingly important role in the detection, quantification and monitoring of atherosclerosis. Ultrasonography, in fact, can provide a simultaneous report of the morphology (dimensions, configuration and wall composition) by echography and the hemodynamics of atherosclerosis by Doppler. Doppler technology has produced more sensitive pulsed Doppler equipment and color codification. These techniques have given the physicians important quantitative (resistance, compliance and stenosis resistance) and qualitative (color-flow imaging) information on delineation of soft plaques, thrombosis and dolicoarteriopathies. By using high-definition echography the normal pattern of intima and media tunics and the relationship between thickening, risk factors and related pathologies have been assessed. The new insight in vascular echography is quantitative vascular echography. This analysis permits the calculation of arterial diameters, plaque mass and vascular volumes. The information obtained could provide important notice on the mechanism of vascular remodelling in the course of atherosclerosis. In conclusion, ultrasonography can provide a complete report of atherosclerosis in clinical practice and research. It is considered the gold standard in the study of the vascular walls and related pathologies.