Acute confusional syndrome (ACS) is a disruption of cognitive function and attention that affects up to 42% of hospitalized patients, most commonly in those over the age of 65. It is typically triggered by one or more precipitating factors in predisposed patients. Point-of-care ultrasound (POCUS) emerges as a tool that could be used to provide quick and accurate information in the diagnosis of patients with ACS, potentially reducing the waiting time for critical interventions, decreasing the need for invasive procedures, and possibly improving clinical outcomes. To date, no articles have been published describing the utility of POCUS in patients with ACS. Therefore, this work presents a review of the utility of POCUS in various pathologies that may be related to the development of ACS. Additionally, we propose an action algorithm that integrates clinical evaluation with bedside ultrasound, which could be useful for allowing quick and accurate identification of the underlying causes of ACS and the guidance of appropriate treatment, although prospective studies are needed to confirm this utility.