Abdominal ultrasonography is an extremely valuable diagnostic tool for all perioperative physicians. While the FAST exam was designed for use in patients with blunt abdominal trauma, its principles are applicable in a wide variety of perioperative settings and can be used to narrow the differential diagnosis in unstable patients. Aortic ultrasound is easy to perform and rapidly confirms or rules out the presence of abdominal aortic aneurysm or dissection. Other uses include gallbladder imaging and evaluation for free intra-peritoneal air. Perioperative and intensive care unit patients will benefit from point-of-care ultrasound, including detailed examination of the abdominal cavity.