Background: Adhesive capsulitis (AC), also referred to as frozen shoulder, represents a prevalent condition, characterized by discomfort and a gradual restriction of both active and passive shoulder movements.  Aim of the work: This work aimed at assessing the efficacy and functional outcome of US-guided corticosteroid injection and US-guided hydro-dilatation among cases developing AC of the shoulder. Patients and methods: Our team conducted a randomized study that included 60 patients of both sexes, with AC of the shoulder. The selected participants underwent a random categorization equally into two groups. Group 1 administered intra-articular injections under ultrasound guidance with a single injection of 40 mg in 1ml of triamcinolone acetate mixed with 2 ml of 2% lignocaine under strict aseptic condition. Group 2 administered intra-articular injections of a mixture of 20 ml of normal saline with 5 ml of lignocaine guided by the US after all sterile precautions were secured. Results: A significant recovery was noted in both groups after 2 and 6 weeks follow up as regards VAS, SPADI score and both active and passive shoulder range of movements with more improvement in the hydro-dilatation group. Additionally, there was a significant difference according to ultrasound findings between before and after treatment in each group. Conclusions: Both methods could be safely utilized as a first-line of intervention for AC treatment focusing on both pain relief and restoring shoulder range of motion. Hydrodilatation can be employed as an efficacious alternative if corticosteroid is discouraged.