Row-column (RC) arrays have the potential to yield full three-dimensional ultrasound imaging with a greatly reduced number of elements compared to fully populated arrays. They, however, have several challenges due to their special geometry. This review paper summarizes the current literature for RC imaging and demonstrate that full anatomic and functional imaging can attain a high quality using synthetic aperture (SA) sequences and modified delay-and-sum beamforming. Resolution can approach the diffraction limit with an isotropic resolution of half a wavelength with low side-lobe levels, and the field-of-view can be expanded by using convex or lensed RC probes. GPU beamforming allows for 3 orthogonal planes to be beamformed at 30 Hz, providing near real time imaging ideal for positioning the probe and improving the operator's workflow. Functional imaging is also attainable using transverse oscillation and dedicated SA sequence for tensor velocity imaging for revealing the full 3-D velocity vector as a function of spatial position and time for both blood velocity and tissue motion estimation. Using RC arrays with commercial contrast agents can reveal super resolution imaging with isotropic resolution below 20 μm. RC arrays can, thus, yield full 3-D imaging at high resolution, contrast, and volumetric rates for both anatomic and functional imaging with the same number of receive channels as current commercial 1-D arrays.