Intravascular ultrasound (IVUS) uses varying-frequency catheter-based transducers for assessment of blood vessel dimensions and morphology. Along with advances in the field of interventional cardiology, IVUS technology has progressed in the last two decades. Dedicated training centers in combination with enthusiasm from a new generation of cardiologists complemented by wellestablished evidence for simplicity, safety and efficacy of IVUS systems have led to increased routine use of this imaging modality. Currently available catheters use sound frequencies in the range of 20–70 MHz, moving from older grayscale IVUS to radiofrequency IVUS (RF-IVUS) and more recently high-definition IVUS (HD-IVUS) devices, some with the ability to differentiate plaque composition.