BACKGROUND: Ultrasound transducer reprocessing is required to prevent the transmission of infections between patients. In some regions, reprocessing practices are not sufficient to achieve high-level disinfection (HLD), which can result in contaminated probes. Furthermore, current manual HLD methods use toxic chemicals and are prone to operator error/variability. The development of automated, non-toxic HLD disinfection devices may reduce the risk of transmission and reduce safety risks for operators and patients. This study investigated the disinfection efficacy of a hydrogen peroxide-based, automated HLD device, the Trophon((R)) EPR, against a range of international standards. METHODS: Disinfection efficacy was assessed in carrier and simulated use tests against 21 different species of bacteria, fungi and viruses. Carrier tests were performed by placing carriers throughout the disinfection chamber and measuring the log reduction in viable organisms following disinfection. These tests were performed according to Association of Analytical Communities International Official Methods and European and ASTM International Standards for bactericidal, fungicidal, mycobactericidal, sporicidal and virucidal disinfection. Simulated use tests involving the disinfection of six widely used ultrasound probe models were conducted according to ASTM-E1837-96 using Mycobacterium terrae as a test organism. RESULTS: The device satisfied criteria for HLD and sporicidal disinfection efficacy under all standards tested. CONCLUSIONS: Automated, hydrogen peroxide-based disinfection devices offer an alternative to manual ultrasound probe disinfection technologies. Such devices reduce the risks of operator error and can improve patient and operator safety by preventing exposure to toxic chemicals. The adoption of next-generation disinfection devices may help to decrease infection risk and improve patient safety.