In daily ultrasound routine, focal liver lesions (FLL) are a frequent random finding. The prevalence is about 5% in the population. With the help of B-mode ultrasound (US) alone, however, not all liver lesions can be reliably characterized, so additional imaging modalities become necessary. Contrast-enhanced ultrasound (CEUS) is a suitable tool to characterize focal liver lesions by an expert with high diagnostic accuracy. Further methods such as the color Doppler mode, superb microvascular imaging (SMI), and elastography can be added and combined into multiparametric ultrasound (mpUS) diagnostics.