The use of ultrasonic guidance to accurately localize nerves, neurovascular sheaths, and vascular structures and to visualize, in “real-time,” needle placement and injectate spread results in safer and more consistently effective regional blockade. Ultrasound guidance is increasingly utilized at our institution for the placement of brachial plexus blocks. This technique, in association with a nerve stimulator, provides the practitioner with the best possible tools to accurately and consistently place solid brachial plexus blocks. We have been utilizing ultrasonographic technology to facilitate the placement of our axillary brachial plexus blocks at the West Virginia University Hospital since 1995 with a very high block success rate. Moreover, we have found that with very little practice novice practitioners can efficiently and effectively place these blocks under ultrasonic guidance with a high rate of success. In this article, we describe our technique for the placement of an ultrasound-guided axillary brachial plexus block.