Background: Perioperative A substantial risk factor for pulmonary aspiration, an uncommon but serious anaesthetic event, is leftover stomach fluid upon induction. The use of bedside ultrasonography to measure stomach contents has recently demonstrated encouraging results, especially in those with abnormal gastric emptying. People in emergency circumstances or with disorders that impede stomach function may not fully benefit from the current fasting recommendations. The purpose of this research was to evaluate the appearance and volume of the gastric antrum using ultrasonography before surgery in individuals having elective surgery and fasting patients with delayed gastric emptying. On the basis of ultrasonography findings, a gastric antrum grading system was suggested. Methods: The 90 participants in this descriptive cross-sectional research were divided into three groups: those with normal gastric emptying (e.g., chronic renal failure, diabetes with autonomic neuropathy) after an eight-hour fast with water consumption, and those without this condition. Gastric volumes were estimated and compared between groups using ultrasound evaluations. Conclusion: Older patients tended to have delayed stomach emptying. The delayed emptying group had substantially larger stomach antrum diameters and projected volumes as measured by ultrasound compared to people who fasted normally. The delayed emptying group had much larger stomach volumes as measured by ultrasonography and nasogastric tube aspirate. In contrast, the delayed emptying group showed inconsistent agreement between ultrasonography and tube measures. In this group, delayed stomach emptying was more common.