Study objectives: Presently, the manipulation and reduction of displaced forearm fractures is done by clinical feel; a repeated radiograph afterward confirms this reduction. Occasionally, factors such as a fat forearm or fracture swelling obscures this feel, and an inadequate reduction results but is discovered only after a repeated radiograph. This inevitable delayed discovery implies a repeated procedure under repeated sedation and a remobilization of patient and manpower. Fluoroscopy by a bulky image intensifier with its increased radiation exposure was until now the only option for real-time viewing of manipulation and reduction. However, with its ever-increasing use in the emergency setting, the portable ultrasonography machine, which images bone with ease, may be a suitable alternative tool. Method: Patients with displaced forearm fractures requiring reduction and who presented while the authors were on shift were recruited into the study during October 2001 to January 2002. We used a 7.5-MHz linear transducer. After giving the appropriate analgesia, a pre–manipulation and reduction ultrasonographic scan was done to correlate with the initial radiograph. After manipulation and reduction, ultrasonography was performed, and treatment was administered accordingly, that is, to repeat the manipulation and reduction or to splint the forearm, which was done until the fracture was thought to be in good alignment clinically and the ultrasonograph showed adequate alignment. A post–manipulation and reduction check radiograph was done only after the clinician was satisfied with the reduction or thought that no further effort would improve the manipulation. The pre- and postreduction ultrasonographic scans and radiographs were examined in the anterior-posterior and lateral planes and were considered to correlate when the ultrasonographic interpretation corresponded with the radiographic findings. Results: This technique was used in a series of 36 forearm fractures. The age of patients ranged from 1 to 14 years; 27 patients were boys and 9 were girls. Of the 36 fractures, 31 (86%) ultrasonographic scans correlated with the confirmed radiographs (4 of these revealed that the reduction was inadequate, which required admission to orthopedics). Five (14%), although interpreted as adequate alignment, did not correlate with radiographs, which showed inadequate reduction, perhaps from improper probe placement. Conclusion: Ultrasonography provides a convenient eye in the manipulation and reduction of pediatric forearm fractures while avoiding excessive radiation exposure.