Emulsion systems are widely applied in agriculture, food, cosmetic, pharmaceutical and biomedical industries. Ultrasound has attracted much attention in emulsion preparation, especially for nanoemulsion, due to its advantages of being eco-friendly, cost-effective and energy-efficient. This review provides an overview for readers to the area of ultrasonic emulsification technology. It briefly introduces and summarizes knowledge of ultrasonic emulsification, including emulsion characteristics, acoustic cavitation, emulsification mechanism, ultrasonic devices and applications. The combination of microfluidics and ultrasound is highlighted with huge advantages in controlling cavitation phenomena and emulsification intensification. A novel scale of dμC0.6/μD0.33−EV is proposed to be able to compare the energy efficiency of emulsion preparation in different devices.