Point of care ultrasound is an important tool for diagnosis of musculoskeletal and vascular pathology in patients presenting to the emergency department. Superficial vascular and soft tissue structures are well-visualized at the bedside using modern ultrasound systems and have image characteristics that can be rapidly identified. This report describes the use of point of care ultrasound to distinguish between rapidly progressive soft tissue infection and vascular injury following penetrating trauma from a cat scratch. Ultrasound allowed the physician to rapidly make accurate decisions about the next necessary steps in the patient’s care. Point of care ultrasound provides immediate diagnostic information to supplement indeterminate physical examination findings. In this case, it allowed the treating physician to make the diagnosis of arterial injury using ultrasound image characteristics. An integrative approach to ultrasonography of superficial musculoskeletal and vascular structures could enhance clinical decision making and improve care of patients with similar complaints.