The dynamic capabilities of ultrasound make it the ideal technique for guiding interventional therapy. A wide range of procedures are now part of the routine armamentarium of the interventional musculoskeletal ultrasonologist. This presentation will review some of the practical aspects of these techniques focusing on the imaging approach, puncture point and target but also emphasising the importance of a rational and systematic approach, particularly the importance of interventional therapy being part of a proper rehabilitation programme. Tendon techniques will include calcium aspiration, dry needle therapy, autologous blood and vessel schlerosant therapy. Bursal injection will include the subacromial subdeltoid bursa, gluteus medius insertion and Mortons neuroma/bursa complex. Other bursae, ganglion cyst detection and aspiration will be included.