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Background: Tendon ruptures are common musculoskeletal injuries all around the world. Correct and timely diagnosis of tendon injuries is obviously important for improving the treatment and minimizing the community costs. Ultrasound is now being considered as one of useful modalities in this area.Objective: The preset study is going to validate the diagnostic ability of ultrasound in tendon injuries induced by penetrating extremity trauma.Methods: In this prospective, observational study, patients with penetrating extremity trauma and suspicion of tendon injuries were enrolled in our study. A team of emergency medicine (EM) residents performed ultrasound examination in these cases after attending the specific workshop and acquiring necessary skills in normal and abnormal tendon ultrasound examination. Then another team of either EM or orthopedic residents explored patients' wounds and determined intact or injured tendons under direct visual observation. The results were analyzed to validate sensitivity and specificity of ultrasound as an alternative diagnostic test.Results: Seventy-one patients were enrolled in our study and 11 patients were excluded during one year in 2014. Sixty patients, 11 with lower extremity and 49 with upper limb injuries were evaluated, among them 32 patients had extensor zone and 28 patients had flexure zone injuries. The overall sensitivity and specificity were calculated 94.4% (95% CI 72.7-99.8%) and 100% (95% 91.5-100.0%) respectively.Conclusions: Our results were similar to previous findings. Ultrasound can effectively differentiate injured from intact tendons in penetrating extremity trauma. [ABSTRACT FROM AUTHOR]