Although ultrasound guidance is occasionally used for abscess detection and aspiration by our radiology colleagues, this is still a very uncommon application in the emergency department (ED). A case is presented of a patient with a difficult-to-drain, recurrent breast abscess. The consulting surgeon was unable to localize the abscess after 15 attempts at aspiration in the ED and requested ultrasound guidance from the attending emergency physician for the procedure. Drainage of the abscess was successfully completed in one attempt with real-time visualization and guidance of the needle. The consulting surgeon requested that ultrasound be available at the patient's follow-up visit to the ED.