This paper covers the literature published between June 2003 and August 2004 on endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (FNA). During this period, more than 120 original studies were published on the topic, not to mention editorials and case reports--indirect evidence of the ever-increasing importance of EUS in everyday clinical practice. However, due to limitations of space, this review will focus only on a few articles selected for their importance and originality. The studies presented deal either with the outcome of EUS--i. e., its real importance in affecting the choices physicians are faced with in their clinical work--or definitively clarify certain technical issues that have often been a matter of debate at EUS meetings. Finally, a few papers describing new potential diagnostic or interventional applications of EUS are presented. Many other relevant papers in addition to those discussed in detail are cited in the references.