Focal liver lesions often occur with or without an underlying liver disease. Contrast-enhanced ultrasonography can aid in characterizing liver lesions, potentially avoiding biopsy and computed tomography procedures. Contrast-enhanced ultrasonography has a high sensitivity and specificity for differentiating characteristics of liver lesions compared with noncontrast sonography. The different contrast characteristics aid in differentiating benign and malignant lesions. Malignant lesions tend to have washout of contrast in the venous phases, whereas benign lesions have hyperenhancement during the venous phases. Therefore, contrast-enhanced ultrasonography should be considered an essential component of the diagnostic process for diagnosing and following focal liver lesions.