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. In the past decade portable ultrasonic equipment has become smaller, much less expensive, and much more user-friendly. More importantly, the frequency of the associated probes has increased from 3.5 to 12 to 15 MHz. This has allowed for the clear and sharp visualization of peripheral nerves. In this article, we will discuss the use of ultrasonic guidance to help facilitate the placement of sciatic nerve blocks between the ischial tuberosity and the greater trochanter just distal to the piriformis muscle.