Meniscal injuries are frequent findings in clinical practice and may arise from acute trauma, progressive degeneration, or joint instability. While MRI remains the gold-standard modality for identifying these lesions, ultrasound has emerged as a valuable complementary technique thanks to its accessibility, low cost, real-time capability, and ability to perform dynamic assessments at the point of care. Increasingly, clinicians and radiologists are relying on ultrasound to detect and characterize subtle meniscal abnormalities that might otherwise be missed or underestimated. This review summarizes the principal static and dynamic sonographic features associated with meniscal tears, complex disruptions, and unstable flap fragments. Particular attention is given to the identification of ramp lesions, which involve the meniscocapsular junction and can be challenging to diagnose using conventional imaging alone. The article also discusses the evaluation of meniscal extrusion, a key indicator of structural compromise and a predictor of osteoarthritic progression. By highlighting characteristic ultrasound patterns and demonstrating how dynamic maneuvers can enhance diagnostic confidence, this work underscores the expanding role of ultrasound as an efficient, patient-centered imaging tool that complements MRI and supports a more comprehensive assessment of meniscal mechanical pathology. These insights ultimately contribute to more accurate treatment planning and improved patient outcomes.