A modified two-dimensional ultrasonic pulse-echo technique was used in the diagnosis of liver disease. In all 36 patients studied an abnormal echo pattern was found. In this selected case material there was a good correlation between the clinical, laboratory, isotopic (gold 198), histologic, and ultrasonographic findings. Because of deficiencies in the present equipment and examining techniques, echography cannot yet give a verdict on the nature of a lesion, but it can distinguish between a solid and a cystic lesion. Ultrasonic examination is a useful screening procedure for liver disease, but it must always be used in conjunction with clinical, x-ray, and laboratory data. This simple, rapid, and safe diagnostic tool deserves more extensive study.