Systems and methods for ultrasonically monitoring implantable medical devices are disclosed. An ultrasonic monitoring system includes an ultrasonic transmitter that transmits an ultrasonic wave into the body, an implantable medical device including at least one ultrasonic reflecting unit configured for reflecting a portion of the ultrasonic wave, and an ultrasonic imaging monitor configured to receive a reflected portion of the ultrasonic wave and produce an ultrasonic image of the implantable medical device within the body. The ultrasonic reflecting unit can include an echogenic fluid medium that reflects a portion of the ultrasonic wave received from the ultrasonic transmitter. The ultrasonic reflecting units can be positioned at various locations on the device to produce localized areas of increased echogenicity, which can be used by the implanting physician to gauge the location of the device within the body.