Motivation Ultrasound is becoming an integral part of medical practice in the Pacific despite the lack of qualified sonographers and the absence of specialist education and training. The Problem Sonography is mostly practiced by radiographers and medical doctors who have acquired skills through an ad hoc system of overseas training attachments, workshops and hands-on training. The modality is highly operator-dependent and the lack of education and training is leading to high levels of variability in accuracy of procedures between personnel. Aims The purpose of this research is to conduct a training needs analysis (TNA) of personnel performing ultrasound and to propose methods of improving ultrasound education in the Pacific. Methods This will be an exploratory study to determine the TNA of ultrasound operators and to find out the current system and effectiveness of existing training programs in the Pacific. Data will be acquired through survey questionnaires, interviews, observation of practice using checklists and patient feedback. Predictions and Results: The outcomes of the study will highlight the knowledge and skills gap of ultrasound practitioners in terms of clinical knowledge and skills, reporting and professionalism. It will also inform of the existing education and skills development programs and the challenges faced by practitioners of ultrasound in the Pacific. Conclusions The findings of the research will lead to provision of evidence based training programs in ultrasound to target local and regional needs in the Pacific and provide networking pathways to begin and enhance ultrasound education. This research is work in progress. The major skills gaps that have already been identified in qualified practitioners are currently being bridged with ongoing short courses and hands-on training activities facilitated by Radiology Across Boarders (RAB) and recently the World Federation of Ultrasound in Medicine (WFUMB). Progress has been made to establish a WFUMB Center of Education in Fiji through which the country would become a regional hub for training ultrasound practitioners.