Ultrasound elastography allows the qualitative or quantitative measurements of the mechanical properties of tissue by applying stress and detecting tissue displacement. This technique is currently being used for the evaluation of various tumor and tumor-like lesions in the breast, thyroid and lymph node in clinical practice. Recently musculoskeletal radiologists have applied ultrasound elastography to a variety of musculoskeletal pathologies. This review introduces a basic sense of the physical principles, potential pitfalls and important limitations in ultrasound elastography for soft tissue tumors.