Pelvic floor insufficiency as a disease is characterized by various symptoms, such as feeling of pressure, voiding disorders, or incontinence. Due to the high incidence and the wide range of symptoms, various medical specialties, including gynecology, surgery, coloproctology, and urology, have patients who present with this clinical picture. Each specialty has developed various diagnostic techniques over time and offer those affected numerous conservative and surgical treatment strategies. Today, however, it is becoming increasingly apparent that a treatment approach focused on part of the pelvic floor is no longer sufficient to treat the combined pathologies of the pelvic floor. In this context, diagnosis is a central point, as it is at the beginning of each treatment path and does not allow errors. This article describes the individual specialty-specific diagnostic tools. Particular attention is paid to sonography, which offers several decisive advantages in the assessment of the pelvic floor. Currently, the measurement methods and the classification of the severity levels differ from specialty to specialty, which results in different and sometimes contradictory treatment options. Using an alternative diagnostic approach can quantify all pelvic floor changes. This alternative approach can be used interdisciplinary for pre- and postoperative assessment of the entire pelvic floor, which in turn serves a continuous improvement of treatment.