In long-distance space travel, managing medical conditions poses significant challenges, primarily due to communication delays between the spacecraft and Earth. This requires onboard physicians to be highly skilled in using diagnostic tools that can operate independently from Earth-based support. Ultrasound has emerged as a valuable tool for this purpose, offering a portable, reliable, and non-invasive way to assess various medical conditions in microgravity environments. While ultrasound’s use in space has been documented, there is still limited comprehensive analysis on its overall effectiveness in handling the unique medical challenges astronauts may face. This review seeks to address that gap by conducting a bibliometric and systematic evaluation of current evidence on ultrasound imaging in space healthcare. The analysis focuses on the tool’s role in diagnosing and monitoring conditions such as musculoskeletal injuries, organ dysfunctions, and cardiovascular anomalies, which are known to be more common in microgravity. Additionally, ultrasound’s capability to function efficiently without gravity-dependent factors makes it a critical asset for both emergency care and routine health monitoring during space missions. The findings suggest that ultrasound is indispensable for real-time diagnostics, helping astronauts maintain their health and well-being during extended missions. Further studies are recommended to refine training protocols and enhance the range of diagnostic capabilities that ultrasound can offer in the unique conditions of space travel.