EUS is one of the most coveted fellowships in Emergency Medicine. Training is typi­cally 1year in length, though there are a few programs that offer multi-year positions in combination with alternative degrees, research experience, or specied focus areas such as international medicine and ultrasound integration. Fellowship training aims to elevate the level of clinical expertise far beyond that of “well-trained residents in EUS.” Fellows receive higher level, focused training and mentoring by his or her fel­lowship director and other EUS-trained faculty members. Scanning technique, limi­tations, pearls and pitfalls and advanced applications are all integrated into the various programs. However, pursuing an ultrasound fellowship will not only increase the fellow’s prociency in the technical aspects of performing bedside ultrasound, but also help acquire administrative skills that are essential to develop a point-of-care ultrasound program. In our era of medicine where reimbursement is a constant chal­lenge and moving target, ultrasound can produce an alternative source of revenue via both direct and indirect mechanisms. This will benet not only the individual clini­cian, but also the emergency medicine group or practice and institution. The exper­tise gained over the course of fellowship can open opportunities whether it be in an academic institution, community hospital, or global healthcare. Choosing a niche such as ultrasound will also increase professional satisfaction and also provide opportunities to reduce clinical workload and prevent burnout.