A keystone in microbubble-mediated drug delivery is the sonoporation phenomenon in which ultrasound-triggered microbubble collapse would generate a cavitational force that is strong enough to puncture cellular membrane. Our current scientific understanding of sonoporation is however quite limited. To properly harness sonoporation for therapeutic applications, it is unarguably vital to characterize the fundamental biophysical processes involved. Of particular relevance are two membrane-level processes that epitomize the notion of sonoporation: 1) how membrane perforation is induced by ultrasound-microbubble interactions, and 2) how the membrane remodels itself following an episode of sonoporation. To monitor cell-microbubble interactions, a real-time imaging platform was developed that coupled a 1 MHz ultrasound module to a confocal microscope. Using this unique platform, the surface topography of plasma membrane was imaged in real-time over the course of sonoporation. Localized perforation of cell membrane was found to be synchronized with the time course of microbubble collapse. The pore size was highly time-dependent: it expanded for a limited time after microbubble collapse (up to 7 um diameter), after which resealing started to take place. The pore size was generally greater than the microbubble (mean diameter: 2.2 um). During recovery, the perforation site exhibited a contractile ring morphology. These findings demonstrate that membrane-level processes in sonoporation are highly dynamic.