The use of transvaginal volume ultrasound has become more and more popular for enabling exact, immediate and non-invasive diagnostics in reproductive medicine. Assessment and analysis (real-time/off-line) of three-dimensional (3D) data sets allow detailed diagnostics of congenital uterine anomalies, intrauterine lesions and ovarian abnormalities. Moreover, functional evaluation of endometrial receptivity and ovarian response rates has been increasingly implemented in the reproductive work-up. Modern ultrasound systems are commonly equipped with newest 3D probes and software application tools but the use in daily practice is frequently restricted to only few indications. This review aims to discuss the technical possibilities and limitations of volume ultrasound in assisted reproduction.