A method for high-speed, freehand ultrasonic elasticity imaging will be described. The method is based on a modified block matching technique. The modification serves two purposes. First, in order to achieve real-time performance a forward prediction mechanism is used to reduce the computational load that a conventional block matching technique requires. Second, in order to accommodate the waveform decorrelation associated with freehand scanning a statistical error detection and correction method was developed. This prevents the displacement estimation errors from propagating to affect a larger area. This new algorithm has been implemented on a Siemens Elegra (a high-end clinical ultrasound imaging system). The initial tests show that the new system can perform B-mode and strain display task at real-time frame rates. The strain images have low noise and excellent contrast. Some results obtained with this system will also be presented. [Support by USAMRAA DAMD17-00-1-0596, NSF BES-9708221, and Siemens Medical Systems is gratefully acknowledged.]