Vascular ultrasound has proven to be a cornerstone for the management of patients with vascular disease, and is utilized by vascular surgeons in the outpatient clinic, the operating room, and for follow-up after revascularisation. Today vascular surgeons are among the most frequent users of ultrasound apart from radiologists. Mastering the skills of vascular ultrasound and interpretation is best acquired under supervision and is more easily learned as part of the daily practice of vascular surgery. Separating vascular ultrasound into basic and advanced procedures is useful, and basic vascular ultrasound skills should be a part of a vascular surgical training program curriculum. In Europe, certification of vascular surgeons in basic vascular ultrasound via a pass-fail test is in its infancy, preceded by local and national initiatives. In the area of clinical vascular research, duplex ultrasound is superior to most other diagnostic modalities due to its availability and noninvasive nature and ultrasound-based research will in addition to improving patient care generate physicians highly experienced in vascular ultrasound.