Ultrasound elastography is a novel imaging modality for evaluating the elasticity of biological tissues. The technique is widely used in oncology to detect and differentiate malignant lesions in soft tissues. Studies have explored use of ultrasound elastography to measure the mechanical properties of muscle in patients with multiple sclerosis spasticity. Real-time elastography was shown to correlate well with subjective scales commonly used to measure MS spasticity. Ultrasound elastography has the potential to become a new objective gold standard to monitor symptom evolution in patients with MS spasticity and to evaluate the efficacy of antispasticity treatment.