The diagnostic value of echoscopy and echography in kidney disease is presented and illustrated. Ultrasound examination is primarily used for the differentiation of cystic and solid lesions of the kidney. Our personal experience and the recent literature on this problem is reviewed. Based on the overall diagnostic accuracy of more than 90%, a procedure to investigate space occupying lesions of the kidney is suggested. The indication for ultrasound scans in obstructive kidney disease and the unilateral nonexcreting kidney is briefly discussed.