STUDY DESIGN: Randomized crossover experiment. OBJECTIVE: To determine whether the Rich-Mar AutoSound™ would be as effective as traditional ultrasound at increasing the temperature of the triceps surae muscle during a 10-min, 1 MHz, 1.0 W/cm2 ultrasound treatment. BACKGROUND: The AutoSound™ is a hands-free ultrasound device that is strapped on the body and left for the duration of the ultrasound treatment. It requires no clinician during the actual ultrasound treatment, thus freeing the clinician to perform other tasks and reducing clinician error during treatments. METHODS: 16 healthy subjects (6 males, 10 females, age = 22 ± 1.6 yrs, height = 173.2 ± 8.4 cm, weight = 72.5 ± 11.3 kg, triceps surae subcutaneous fat thickness = 0.85 ± 0.37 cm) received a 10-min, 1 MHz, 1.0 W/cm2 ultrasound treatment over their left triceps surae muscle with both the AutoSound™ and traditional ultrasound (via the TheraHammer™) with 24 hours between treatments. Temperatures were measured every 30 seconds during the ultrasound treatments by way of a thermistor, approximately 2.25 cm deep in the triceps surae. RESULTS: The AutoSound™ was not effective at increasing the temperature of the triceps surae muscle, as temperature decreased 0.16°C during treatment (p = 0.334). On average, the AutoSound™ caused intramuscular temperature to decrease at a rate of 0.016 ± 0.001°C per min. Traditional ultrasound performed using the TheraHammer™ had a total temperature increase of 0.41°C. Rate of temperature increase during traditional ultrasound was 0.025 ± 0.003°C per min (p < 0.0001). CONCLUSION: The AutoSound™ is not as effective at increasing muscle temperature as traditional ultrasound during a 10-min, 1 MHz, 1.0 W/cm2 treatment. However, neither the AutoSound™ nor traditional ultrasound was very effective at increasing the temperature of the triceps surae muscle during the treatment time.