In the critically ill patients, to perform an invasive procedure under the ultrasound guidance (USG) is possible to improve the success rate and to reduce the complications. However, the reason for USG procedure not to be widely spread, is due to be a lack of skilled clinicians and to be difficult to perform the procedure 24 hours period. In an attempt to overcome these problems, we have built the consultation system in the emergency department (ED) about USG procedures. Through experiences with the system, we have aimed to investigate the safety and availability of USG catheterization by ED. We have reviewed the medical records of consultation to ED from March 2009 to February 2014 retrospectively. Also we have reviewed the increasing rate of procedure number, type of procedure, number of consultation from the other department, number of failed procedure as well as the number of complication. There were 532 cases that have been consulted for the USG procedures for 5 years. There were 184 cases in 2013, and has been increased 4.7 times since 39 cases in 2009. The consultation were mostly by Internal medicine (341; nephrology 118, gastroenterology 60, pulmonology 56), General Surgery’ (60), Obstetrics and Gynecology (42), and Neurology (26). The procedure of vascular access (446, 83.8%; central line 332, Gambro catheter in 124), paracentesis (51, 9.6%), thoracentesis were mostly requested by other department. We have observed 4 cases of process failure during the accessing the vascular access, 11 cases of thoracentesis due to lack of exudate. While performing USG procedures by ED, we have observed the high success rate, low complication rate and increasing frequency of consultation in vascular access. With these result, USG procedures by ED affect the spread of these procedures in other departments.