A digest is provided of work carried out at the Institute of Cancer Research to develop freehand elastography and apply it to breast investigations. Topics covered include the development of freehand elastography and its relationship to other methods, a description of the system for off-line clinical evaluation of the freehand method, comparison of the physical performances of freehand and mechanical elastography, early clinical results on 70 breast tumours, real-time imaging, quantitative elastography and psychophysical aspects of the detection and assessment of elastic lesions. Progress in developing this new medical imaging modality is occurring rapidly throughout the world and its future looks promising.