In this second part of a review of pelvic floor ultrasound imaging, current three-dimensional (3D) ultrasound technology and its use for imaging pelvic floor structure and function is described. Recent technical developments enable rapid automated volume acquisition in real time, and currently available transducers designed for abdominal use are well suited for translabial/transperineal imaging. To date, such systems have been used to image the urethra, the levator ani and paravaginal supports, prolapse and implants used in pelvic floor reconstruction and anti-incontinence surgery. While 3D pelvic floor imaging is a field that is still in its infancy, it is already clear that the method has opened up entirely new opportunities for the observation of functional anatomy. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.