Research on ultrasonic treatment (UST) of aluminium, magnesium and zinc undertaken by the authors and their collaborators was stimulated by renewed interest internationally in this technology and the establishment of the ExoMet program of which The University of Queensland (UQ) was a partner. The direction for our research was driven by a desire to understand the UST parameters that need to be controlled to achieve a fine equiaxed grain structure throughout a casting. Previous work highlighted that increasing the growth restriction factor can lead to significant refinement when UST is applied. We extended this approach to using the Interdependence model as a framework for identifying some of the factors (e.g., solute and temperature gradient) that could be optimised in order to achieve the best refinement from UST for a range of alloy compositions. This work confirmed established knowledge on the benefits of both liquid-only treatment and the additional refinement when UST is applied during the nucleation stage of solidification. The importance of acoustic streaming, treatment time and settling of grains were revealed as critical factors in achieving a fully equiaxed structure. The Interdependence model also explained the limit to refinement obtained when nanoparticle composites are treated. This overview presents the key results and mechanisms arising from our research and considers directions for future research.