The present disclosure is directed to an ultrasound imaging system with an integrated needle advancer. More specifically, the ultrasound imaging system includes an ultrasound probe having a transducer housing, a transducer transmitter, a needle assembly, and a controller. The transducer housing has a body that defines an internal cavity. The internal cavity includes a passageway extending from a proximal end to a distal end of the body. The needle assembly is configured within the passageway of the internal cavity. The transducer transmitter is configured within the distal end of the body. Further, the transducer transmitter is configured to emit and receive ultrasound beams. Thus, the controller is configured to generate an image from the ultrasound beams. Figure 1