AIMS AND OBJECTIVE: The objective of this study was to evaluate the role of a handheld USG of 7-13 MHz in evaluating meniscal lesions of knee and comparing it to the results obtained with magnetic resonance imaging. MATERIAL AND METHODS: A comparative double blind study was done between ultrasonography and MRI of fifty patients with a history of knee trauma or with suspected knee meniscal lesions, who were referred to the department of Radiodiagnosis. MRI and USG results were finally correlated with arthroscopy findings. All these patients had a significant history and clinical evaluation suggested meniscal lesion of the knee joint. Cases which have been operated previously on the same knee were excluded from this study. RESULTS: Out of the 50 patients, a total of 100 menisci were examined, out of which after final arthroscopy confirmation, 34 had meniscal tears, 3 degenerative tears, and two patients had meniscal cysts both of which were not associated with a tear of the meniscus. CONCLUSION: The specificity of USG matched that of MRI and it can reasonably be applied to confirm the clinical diagnosis before undertaking arthroscopy. However, the lower sensitivity suggests that there is still a need to improve the technique to reduce the number of false-negative diagnoses and thus to avoid unnecessary arthroscopy. USG may be used as a screening tool prior to arthroscopy in selected cases where MRI is a contraindication or is not available or if the patient is not affording.