Urgent medical intervention may be required for abnormal uterine bleeding (AUB) in adolescents presenting to the emergency department (ED). Currently existing guidelines sometimes evaluate AUB first with pelvic ultrasound (PUS); even the American College of Obstetricians and Gynecologists defers PUS-ordering decisions to provider discretion. Copyright (C) 2024 Wolters Kluwer Health, Inc. All rights reserved.