BackgroundMusculoskeletal ultrasound imaging (MSUI) is an efficient monitoring and re-evaluation tool used for the management of musculoskeletal conditions in several clinical domains. Its utilization among physiotherapists, particularly in African countries, is yet to be explored.ObjectiveThis study investigated the knowledge, attitude, and perception of physiotherapists on the utilization of MSUI in the clinical management of musculoskeletal conditions.MethodsOne hundred and ninety-two consenting Nigerian-based physiotherapists practicing in public and private health institutions participated in this cross-sectional survey. They responded to a three-sectioned structured questionnaire, investigating socio-demographic and occupational characteristics, knowledge, attitude, and utilization of MSUI for the management of musculoskeletal conditions. Data were analyzed with descriptive statistics and Pearson’s chi-square test at a significant level of 0.05.ResultsThe majority (79.2%) of the respondents had positive knowledge of MSUI and its benefits as a clinical modality for managing MSCs. However, only 4.2% had utilized MSUI in clinical practice. Non-utilization of MSUI was commonly attributed to a lack of access to MSUI (60.3%) and its unavailability in most diagnostic centers (42.9%). Almost all (99.0%) of them agreed to the necessity for increased availability of MSUI to physiotherapists for enhancement of physiotherapy interventions in the management of MSCs.ConclusionKnowledge of MSUI among Nigerian-based physiotherapists is adequate, but its utilization as a clinical tool is poor. Improved availability of MSUI to physiotherapists is necessary as well as specialty training on the utilization and interpretation of MSUI.