Objective:To investigate the current status of ultrasound professionals and ultrasound equipment in medical institutions across Shanghai, and to provide an evidence-based foundation for strengthening workforce management and disciplinary development.Methods:A questionnaire survey was conducted to collect data on sonography staff and ultrasound equipment in Shanghai medical institutions during 2025. Longitudinal comparisons were made with historical survey data from 2013 and 2018. The chi-square (χ2) test was used to compare differences in workforce structure and equipment allocation across hospitals of different grades, and the Bonferroni method was applied for pairwise comparisons between tertiary hospitals and secondary, primary, and private hospitals.Results:A total of 512 medical institutions in Shanghai were enrolled, comprising 55 tertiary hospitals, 77 secondary hospitals, 229 primary hospitals, and 151 private hospitals. (1) Workforce structure in 2025: a total of 3008 sonography professionals were included, of whom 80.3% (2414/3,008) were female. The total workforce increased by 19.9% and 58.1% compared with 2018 and 2013, respectively. There were 1279 sonography professionals aged ≤40 years (42.5%), of whom 58.7% (751/1279) worked in tertiary hospitals. A total of 203 sonography professionals were aged ≥60 years (6.8%), and 63.1% (128/203) of these were employed by private hospitals. The educational background and professional title composition of the workforce improved compared with previous years. Physicians with doctoral and master's degrees accounted for 9.8% and 21.4%, respectively, while intermediate and senior professional titles accounted for 54.8% and 21.8%. Tertiary hospitals had a higher proportion of staff with advanced academic degrees and senior titles, whereas primary and private hospitals concentrated staff with lower educational attainment. The mismatch rate of practicing scope among sonographers was 4.1%, and the overall possession rate of color Doppler flow imaging (CDFI) certification reached 72.3%. (2) Equipment allocation: there were 2627 ultrasound devices in Shanghai in 2025, representing an increase of 23.7% versus 2018 and 62.5% versus 2013, with domestically manufactured equipment accounting for 23.5%. Tertiary hospitals held 48.6% of all ultrasound devices citywide, with the highest average allocation of 23 units per hospital. New devices with a service life ≤5 years constituted 52.2% of the total inventory, while outdated equipment used for ＞10 years accounted for 10.4%. Private hospitals had only 3.2% of equipment with a service life ＞10 years, a proportion lower than that observed in other hospital tiers. (3) Comparisons among hospitals of different levels: overall comparisons of the constituent ratios of educational background, professional title, age, working years, and CDFI possession rate among ultrasound professionals, as well as the origin and service life of ultrasound equipment, revealed statistically significant differences across hospital grades (χ2=1050.75, 39.92, 423.17, 77.76, 9.05, 25.10, and 58.25, respectively; all P＜0.001). Pairwise comparisons demonstrated that educational background, professional title, age, working years, and equipment service life differed significantly between tertiary hospitals and other types of hospitals (all P＜0.0167), whereas no significant differences were observed in CDFI possession rate. Regarding equipment origin, a statistically significant difference was found between tertiary and primary hospitals (χ2=11.32, P=0.001), while no significant differences were identified between tertiary hospitals and secondary or private hospitals.Conclusion:The number of ultrasound professionals and ultrasound devices in Shanghai has increased steadily, accompanied by an overall improvement in workforce structure, with superior resources concentrated in tertiary hospitals. Nevertheless, challenges remain prominent, including inadequate qualification supervision, uneven distribution of medical resources, and insufficient talent reserves at grassroots institutions. Integrated strategies encompassing talent training, certification administration, and equipment deployment should be implemented to advance the homogenized quality of ultrasound medical services in Shanghai.