Purpose of review The purposes of this review are to explore the history of the diagnostic ultrasound and its use in medical care and to report on the latest findings on the utility of ultrasound during the transport of patients. Recent findings The Neonatal Ultrasound in Transport (NUiT) study demonstrated the feasibility and utility of ultrasound assessment prior to the retrieval of critically ill newborns to a higher level of care. It is feasible to carry a laptop ultrasound with the transport team without hindering flight or retrieval processes. The NUiT study demonstrated that many term babies had evidence of clinically unsuspected haemodynamic compromise. Other babies had clinically unsuspected abnormal heart structure allowing for redirection of transport toward paediatric cardiology centres. The preterm cohort revealed many babies with clinically unsuspected low systemic blood flow and stable head ultrasound findings pre- and post transport. This has implications for therapeutic targeting of treatment and for counselling parents. Summary Clinician-performed ultrasound (CPU) during the retrieval of neonates confirms a high incidence of haemodynamic pathology. Ultrasound in retrieval is feasible, allows the accurate triage of babies to cardiac centres and may allow more accurate and earlier targeting of fluid and inotropic support.