This article discusses a case in which ultrasound was the primary modality for diagnosis of traumatic patellar tendon rupture. Traditionally, this diagnosis has been made using MRI. This case highlights the growing need for emergency medicine physicians to become facile with bedside ultrasound and its indications as a supplement to traditional musculoskeletal examination. Normal and pathological patellar tendon examinations with ultrasound are discussed in detail. Furthermore, the advantages of ultrasound over the more traditional imaging modalities of x-ray and MRI in cases where tendon rupture is suspected are discussed.