Abdominal-pelvic ultrasounds ordered or performed in the ED are used to diagnose life-threatening obstetrical or gynecological diseases that may require emergent surgery. Nonpregnant patients with lower abdominal pain, pelvic pain, or tenderness on bimanual examination are also candidates for a pelvic ultrasound in order to rule out ovarian torsion or tubo-ovarian abscess. Pelvic ultrasound is also capable of helping guide the emergency physician in the management of other non-emergent obstetrical/gynecological disease processes, such as incarcerated uterus, abnormal intrauterine pregnancies, no definitive pregnancies, and ruptured ovarian cysts. This chapter includes gynecological normal images of the uterus, ovaries, and bladder in sagital and coronal planes. It also presents obstetrical normal images of the uterus and ovaries in sagital and coronal planes, and pathological images of the uterus, ovaries, and adnexa in sagital, coronal, and some oblique planes.