Contrast-enhanced ultrasound (CEUS) is a powerful imaging modality for the diagnosis of focal liver lesions, including hepatocellular carcinoma (HCC). The American College of Radiology Contrast-Enhanced Ultrasound Liver Reporting and Data System (CEUS LI-RADS?) was created as a standardized reporting system to facilitate consistent and high-quality technique, interpretation, reporting, and data collection for CEUS diagnosis of HCC. This article describes the history and background of CEUS LI-RADS?, its major concepts and algorithm, and the differences between CEUS LI-RADS? and CT/MRI LI-RADS?.