Obstetric ultrasound examination is a useful diagnostic procedure for family physicians who select appropriate equipment, observe indications, understand limitations, and work toward performance mastery. The knowledge obtained during an examination assists clinical decision making and reduces liability. This is particularly true for rural and underserved communities where family physicians provide the majority of prenatal and comprehensive perinatal care. Mastery of obstetric ultrasound techniques can also lead to developing amniocentesis skills and serve as an aid to external cephalic version. The equipment does not require extensive maintenance and is available at all hospitals. Many offices and group practices have found purchase of this equipment to be cost effective. Based on clinical experience in family practice and a review of the medical literature, an approach to skill acquisition and quality assurance is described.