Abstract: During the past 30 years, I enjoyed not only the practice of fine-needle aspiration (FNA) but also teaching it. Back in the late 1970s, FNA was a totally new addition to general surgical pathology. At that time, I tended to get 2 common questions. The first was generally from the senior member of the pathology group who is happy with the traditional practice of surgical pathology and wanted to know why his practice should include FNA. The second question was generally from a younger member, often in the same group, who wanted to know how he could “sell” the idea of FNA to his reluctant senior colleagues. After introducing ultrasound-guided FNA into my Sacramento private practice in 2003, I enjoyed the irony of getting exactly the same questions but now with an ultrasound twist. Again, the senior members of the pathology group wanted to know why it was necessary at ultrasound guidance to establish manual FNA practice, and the junior member of the group wants to know how to convince his senior colleagues to do exactly that. In this review, I provide very practical, practice-tested answers to those 2 questions plus 3 other practical questions as follows: how to evaluate an ultrasound machine, what books and courses are the most cost-effective, and how does one market ultrasound-guided FNA to doctors and patients.