While ultrasound (US)-guided placement of peripheral nerve blocks is rapidly gaining popularity, expert practitioners agree that two of the most significant barriers to safety and efficacy are keeping the needle tip within the image and unintentional probe movement during the procedure.1 In addition, placing a nerve catheter past the needle tip under direct US observation requires two practitioners: one to hold the US probe and needle and another to advance the catheter. We present a case of a needle guidance system that attaches to the ultrasound probe and facilitates in-plane imaging. It enables a single practitioner to successfully execute a popliteal sciatic nerve block and visualize catheter placement. Therefore, a needle guidance system may represent an additional modification to ultrasound imaging that increases both time efficiency as well as safety.