Ultrasonography of adrenal lesions is usually difficult because of its high location in the posterior abdomen. On the posterior scan, it may be easily obscured by ribs; on the anterior scan, by stomach or bowel gas (especially on the left side) as well as ribs. Multiple approaches from anterior, posterior and poster-lateral positions and longitudinal, transverse and oblique directions may be necessary to delineate the adrenal area. Ultrasonography of the normal adrenal gland is most difficult because the normal adrenal gland is usually only 3 to 6 mm in thickness. However, with careful scanning and different approaches, it is frequently possible to delineate the normal adrenal gland and adrenal masses as small as 1.3 cm in size may be identified.