The U.S. Department of Health and Human Services Office of the Inspector General has issued a report concerning “high use” and “questionable use” ultrasound. Findings include those geographic areas where occurrences are most frequent, as well as the most common elements that characterize questionable use. While not its primary focus, emergency physician performed bedside ultrasound is within the scope of the report. Implications for emergency ultrasound are discussed and practice recommendations made for minimizing regulatory exposure for emergency physicians and departments.