Intraoperative ultrasound (IoUS) has been a time tested modality to assist surgeons in various procedures. It is inexpensive, and a highly useful intra-operative aid for neurosurgeons operating on spinal tumours as it helps confirming the limits of tumour, margins of resection and assuring gross total resection.. This review discusses the utility of IoUS in the diagnosis, resection, and monitoring of spinal tumours, highlighting its ability to guide tumour localization, assess resection margins, and minimize complications such as neural and vascular injury.