B-mode ultrasound imaging is optimized for a users region of interest. For B-mode imaging, a region of interest is determined. Some indication of a location or locations of interest to the user in the B-mode image is used to identify the region of interest. The parameters used for B-mode imaging are then set based on the identified region of interest rather than an entire B-mode field of view. Subsequent B-mode imaging is performed with these parameters optimized for the region.