Savelli L, Ambrosio M, Salucci P, et al. - A step-by-step technique was shown by researchers to determine normal uterosacral ligaments (USLs) during transvaginal ultrasound. In the posterior compartment, the most common location of deep infiltrating endometriosis (DIE) is uterosacral ligaments and their involvement has been identified to significantly enhance the risk of ureteral lesions. In the video, a 33-year-old nulliparous woman was shown who was scheduled for laparoscopic removal of a para-ovarian cyst of nearly 6 cm. In another four patients submitted to laparoscopy for benign diseases, repetition and confirmation of the procedural steps were performed. The right position of USLs was correctly determined via performing an ultrasound during a surgical procedure; in this way the area of interest can be recognized while the surgeon filled the pouch of Douglas with fluid and highlighted the anatomical area with pliers. Uterosacral ligaments can be identified in the mid-sagittal and transverse view of the uterus. Transvaginal ultrasound displayed uterosacral ligaments as hyperechoic stripes beginning from the cervix and pointing laterally in a semi-horizontal direction.