The popularity of gluteal augmentation has surged in recent decades, primarily due to satisfactory aesthetic results. The primary goal of this retrospective analysis was to present the key characteristics of a large patient cohort from Europe, comprising 185 female patients who underwent gluteal augmentation with ultrasound-guided fat grafting. A retrospective analysis was conducted on 185 female patients who underwent gluteal augmentation with ultrasonic liposuction and fat grafting from February 2020 to July 2023. The procedures were performed in accordance with the latest safety recommendations. Information concerning the patient demographic, volume of fat graft, and complications was analyzed. Additionally, patient satisfaction was evaluated through a questionnaire. The mean Body Mass Index (BMI) of the patients was 23.00 kg/m (SD = 2.62). Furthermore, the volume of transferred fat graft ranged from 500.00 mL to 800.00 mL, with a mean of 596.75 mL (SD = 67.29). The most frequent complication was the formation of seroma (5.41%). All complications were treated successfully. Using ultrasonic liposuction and ultrasound-guided fat grafting to enhance buttock contours is a reliable technique. Nevertheless, it is crucial to exert caution and take all necessary steps to reduce the risk of potentially life-threatening complications.