S exam guide
About the Sonography (S) exam
The ARRT Sonography examination assesses patient care, ultrasound image production, and a broad range of abdominal, obstetric, gynecologic, superficial, vascular, and interventional procedures. The examination is unusually long and rewards durable technical reasoning, systematic scanning, anatomy recognition, and pathology discrimination.
MedPorium is an independent education platform and is not affiliated with or endorsed by The American Registry of Radiologic Technologists (ARRT). Exam details can change; confirm them with the official source before applying.
S exam format at a glance
- Questions
- 400
- 360 scored; 40 unscored
- Time
- Two test sessions totaling 390 minutes, plus a 30-minute break, within a 440-minute appointment
- Delivery
- Computer-based testing at Pearson VUE test centers
Knowledge to review for the S exam
These foundations support the practical tasks in the official examination matrix.
Patient care and professional practice
- History, indication, consent, communication, positioning, transfers, infection control, emergencies, ergonomics, bioeffects, documentation, and procedures
- Laboratory data, prior imaging, medications, pregnancy care, pediatric and geriatric needs, and critical findings
Ultrasound image production
- Sound propagation, transducers, pulse parameters, focusing, resolution, attenuation, output, bioeffects, display modes, and instrumentation
- B-mode, M-mode, spectral, color and power Doppler, hemodynamics, harmonics, compounding, elastography, contrast, artifacts, optimization, and quality assurance
Clinical sonography procedures
- Abdomen, retroperitoneum, pelvis, obstetrics, gynecology, breast, thyroid, scrotum, superficial structures, neonatal brain, and musculoskeletal applications
- Anatomy, physiology, pathology, measurements, protocols, Doppler, transplants, interventions, emergencies, and image correlation
S examination matrix
The percentages below are the approximate exam-score weights published by The American Registry of Radiologic Technologists (ARRT). Use them to allocate study time, then adjust for your own weak areas.
7.2%
Patient Care
Prepare, protect, communicate with, and clinically assess patients while maintaining safe and professional practice.
- Verify indication, history, preparation, labs, prior imaging, consent, and patient identity
- Apply positioning, transfers, infection control, ergonomics, emergency response, and acoustic-output safety
- Communicate, document, and escalate significant or critical findings appropriately
32.8%
Image Production
Apply ultrasound physics, instrumentation, Doppler, hemodynamics, optimization, artifacts, bioeffects, and quality assurance.
- Relate frequency, pulse parameters, focus, aperture, attenuation, resolution, and output to image quality
- Optimize B-mode, M-mode, spectral, color, and power Doppler for anatomy and flow
- Recognize artifacts, measurement errors, equipment faults, and quality-control concerns and correct them
60%
Procedures
The dominant area covers anatomy, physiology, pathology, protocols, measurements, Doppler, interventions, and special populations across sonographic examinations.
- Perform and evaluate abdominal, retroperitoneal, pelvic, obstetric, gynecologic, and superficial-structure examinations
- Identify normal, variant, congenital, inflammatory, obstructive, vascular, neoplastic, traumatic, and post-treatment findings
- Adapt scans for transplants, pediatrics, pregnancy, emergencies, procedures, body habitus, and limited mobility
How to use this S diagnostic
The diagnostic samples all three current areas, but it cannot reproduce the endurance demands of the two-session examination. Review each miss by organ system and by technical cause: preparation, anatomy, physiology, transducer and setting selection, Doppler, artifact, pathology, measurement, documentation, or intervention.
High-yield S study priorities
Priority 1
Build system-based scan maps
For each examination, know preparation, sequence, landmarks, planes, measurements, Doppler, variants, pathology, documentation, and stopping points.
Priority 2
Make Doppler quantitative
Practise angle correction, scale, baseline, wall filter, gain, sample volume, aliasing, waveform analysis, indices, and hemodynamic interpretation.
Priority 3
Compare look-alike pathology
Use paired cases with overlapping grayscale or Doppler findings and separate them using location, clinical data, vascularity, behavior, and associated signs.
Priority 4
Train examination endurance
Progress from short focused sets to long mixed blocks while maintaining a deliberate image-analysis sequence and scheduled-break strategy.
S exam FAQ
How many questions are on the ARRT Sonography examination?
The current examination format contains 400 questions: 360 scored questions and 40 unscored pilot questions. Pilot questions are mixed into the examination and are not identified.
How long is the Sonography examination?
Two test sessions totaling 390 minutes, plus a 30-minute break, within a 440-minute appointment. ARRT's appointment time also includes the tutorial, nondisclosure agreement, and survey where applicable.
How is the content outline weighted?
The currently effective specification is approximately Patient Care 7.2%, Image Production 32.8%, Procedures 60%. These percentages are calculated from ARRT's scored-item counts, so rounding may prevent the displayed values from totaling exactly 100%.
What should I prioritize for Sonography?
Procedures is the largest scored content area at approximately 60%. Give it the largest share of practice, but continue sampling every area because the examination blueprint is broad.
What score is required to pass an ARRT examination?
ARRT reports examination results on a scaled score from 1 to 99, and a scaled score of 75 is required to pass. A 75 scaled score is not the same as answering 75% of questions correctly.
Does this diagnostic predict whether I will pass?
No. A 15-question diagnostic is a low-confidence baseline, not a validated pass prediction. Review every rationale and use larger mixed and content-specific sets to build a more stable readiness estimate.
Is MedPorium affiliated with ARRT?
No. MedPorium is an independent education platform and is not affiliated with or endorsed by The American Registry of Radiologic Technologists.
Review and official source
Clinical reviewer: H. H. Smith
Exam format and matrix information were checked against the ARRT Sonography credential page and examination content specifications. Source reviewed October 15, 2026.
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