The arteriovenous gradient is a crucial determinant of organ perfusion; however, it is often overlooked in clinical practice, with greater emphasis placed on arterial pressure and cardiac output. This consideration becomes particularly significant in the management of critically ill patients. The integration of VExUS into clinical practice enhances the precision of fluid management, allowing for tailored decongestive strategies that optimize patient outcomes. As research continues to validate its application across various settings, the VExUS score represents an evolving tool in the assessment of hemodynamic status, improving our ability to identify and manage venous congestion effectively.