Rock grouting is performed to decrease the hydraulic conductivity around underground structures, such as tunnels and caverns. Cement grouts are often used and pumped into joint and fractures of the rock formation. Piston type pumps are mostly used for high pressure rock grouting. A pulsation effect is inevitable when using this type of pump due to the movement of the piston. The effect of this pulsation on rock grouting is yet to be known but believed to be beneficial for the penetration of the grout. Current flow meters used in the field are not accurate enough to determine the fluctuation of the flow rate when it is less than 1 l/min. In addition, currently available flow meters measure the average of the flow over a certain period of time, hence the true fluctuation of the flow rate due to the pulsation of the piston remains unknown. In this paper, a new methodology, the so called ‘Ultrasound Velocity Profiling – Pressure Difference’ (UVP+PD) method has been introduced to show the pulsation effect when using a piston type pump. The feasibility of this method was successfully investigated for the direct in-line determination of the rheological properties of micro cement based grouts under field conditions (Rahman & Håkansson, 2011). Subsequently, it was also found that this method can be very efficient to measure the fluctuation of the flow rate for different types of pumps. From a grouting point of view the UVP+PD method can be used to synchronize the pressure and flow of a piston type pump by measuring the pulsation effect. Consequently it can be used as a tool for the efficiency and quality control of different types of pumps.