Asian elephants possess a unique pulmonary anatomy that presents challenges for diagnosing respiratory diseases, particularly when reared under human care where environmental stressors, poor hygiene and limited physical activity predispose them to respiratory pathologies. Conventional diagnostic tools such as radiography, computed tomography (CT), and magnetic resonance imaging (MRI) are impractical for elephants due to their large body size. Diagnosis of lung pathologies is often delayed until postmortem. This study evaluated the diagnostic utility of lung ultrasound (LUS) as a noninvasive, real-time imaging modality in assessing lung health in Asian elephants.