The usefulness of thoracic ultrasound (TU) in specific extreme sports, namely, skateboarding, skiing, apnea diving, climbing, mountaineering, and Ironman races, has already been established. Extreme sports are often practiced in remote locations, and evacuation of participants after trauma may require complicated terrestrial rescue operations or the use of helicopters or specific watercrafts. Potentially life-threatening conditions may be quickly assessed with TU directly on the scene without any delay in the evacuation. Therefore, the use of TU for chest trauma in extreme sports is one of the most promising areas for future applied studies. In extreme sports, TU may be used to assess the increase in lung fluid content. Pulmonary Edema (PE)can affect participants of particular extreme sports, such as the one that are exposed to hypo- and/or hyperbaric condition, such as climbers exposed to high altitude (above 4000 m), and divers exposed to a depth of −100 m under the sea level. In these settings, PE may occur as a result of a combination of hemodynamic, mechanical, hypoxemic, and biochemical mechanisms. However, also in the normal environment, ultraendurance extreme sports may cause lung tissue and microvascular endothelial damage, as a consequence of thermal, hormonal, and metabolic stress. After Ironman race (which consists of swimming required for a distance equal to 3.86 km, riding a bike for a distance equal to 180 km, and running a marathon), TU detected a significant increase of B-lines. This was associated with a decrease in spirometric indices as well as in ventilatory performance. In some cases, the transient subclinical increase in lung fluid content may represent a paraphysiological adaptation, but in others, it may represent an important marker of individual vulnerability to potentially life-threatening PE. (Feletti, et al. Can Respir J, 2018 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875054/)