Foreign material may present both a diagnostic and a surgical problem. Most irretrievable foreign bodies are wood and are radiolucent. Ultrasound offers an alternative way of preoperative imaging in these situations. We describe four cases of retained splinters in the hand that were localized with sonography and subsequently removed surgically. This report supports the reliability and efficiency of ultrasound as the primary imaging tool for the detection of foreign bodies if conventional radiographs are negative. Preoperative sonographic localization of the foreign body may be extremely useful to the surgeon and may minimize surgical dissection and operating room time.