The paired uterosacral ligaments (USLs) are important supportive structures of the uterus and the apical vagina. Weakened or damaged USLs play an important role in the pathophysiology of pelvic organ prolapse. Besides, they have been also reported to be the most common side of deep endometriosis in pelvis. This video presents our technique to identify and assess the USLs by transvaginal ultrasound in pre- and intra-operative settings. The knowledge of the USL morphology & location may increase the detection rate of (endometriotic) lesions affecting these structures.