Sonography is an integral part of the routine diagnosis of diseases of the head and neck area. Ultrasound plays an important role in particular in the diagnosis, treatment and follow-up of head and neck cancer. Sonographic imaging of the larynx, hypopharynx and upper esophagus is often difficult due to the anatomical conditions. Therefore, CT and MRI are performed as the imaging techniques of first choice for diseases of these organs. In addition to the well-established transcutaneous ultrasound, endoscopic endoluminal ultrasound has developed as a promising new technique in recent years. Hollow organs can be displayed in high resolution transcutaneously and endoluminally. Thus, the attending otolaryngologist can use endoscopy and ultrasonography for accurate surgical planning. The aim of the present paper is to present the possibilities and limitations of ultrasonography of the larynx, hypopharynx and upper esophagus.