Background and Objectives: The science of Diagnostic ultrasound is perhaps the most promising of the imaging modalities currently available. The main objective of this study is to establish the efficacy of ultrasonography to detect various hepatobiliary lesions and provide necessary information, aiding in their appropriate management. Methods: This study, carried over a period of two years, included 150 patients with various hepatobiliary lesions. There were patients of both sexes and their ages were above 5 years and below 85 years. After the routine blood and urine investigations and liver function tests, the patients were subjected to ultrasound examination. Results: One fifty cases, aged between 5 and 85 years, with various hepatobiliary lesions were studied with real time ultrasonography. The most frequently encountered Gall bladder lesion was Gallstones (44) with associated chronic cholecystits in 32 cases, acute cholecystitis in 10 cases, Gall bladder carcinoma in 2 cases. There were 3 cases of GB polyp, 2 case of chronic cholecystitis, 1 case of CA Gallbladder which were not associated with gall stones. Among the CBD lesions there were 2 cases of choledocholithiasis, 2 cases of cholangiocarcinoma and 1 case of choledochal cyst. The most frequently encountered focal liver lesion in this study was amoebic liver abscess which was found in 20 cases. The second most commonly encountered focal liver lesion was hepatocellular carcinoma which was found in 12 cases. 10 cases with hepatic metastasis were found. 4 cases with ultrasound features highly suggestive of haemangioma and 2 cases with hepatic hydatid disease were found. One case each of an intrahepatic haematoma and a simple liver cyst was found. Among the diffuse liver diseases, the most commonly encountered was fatty liver which was seen in 16 cases. The second most common diffuse liver disease was cirrhosis which was seen in 12 cases. 10 cases of acute hepatitis, 4 cases of chronic hepatitis and 3 cases of congestive liver was found. Conclusion: Ultrasound proved to be a sensitive, easily available and safe imaging modality for the diagnosis and follow-up of various hepatobiliary lesions and should therefore be the first line of investigation in suspected cases.