Pulmonary aspiration during anaesthesia induction is a serious adverse event that can lead to catastrophic consequences for the patient, including death. Preoperative fasting has so been assessed on the basis of the clinical history and fasting schedules recommended by clinical guidelines. This assessment is not objective, since the presence or absence of gastric contents cannot be guaranteed. Gastric point of care ultrasound (POCUS) is an objective, simple, and rapid method for assessing fasting prior to anaesthesia induction that stratifies risk and aids in decision-making. The aim of this review is to summarize the existing literature on gastric POCUS in the assessment of preoperative fasting. For this purpose, the Pubmed and Embase were searched for relevant studies published between 2014 and 2024.