Ultrasound elastography (USE) assesses tissue stiffness, adding supplemental information to real-time dynamic transvaginal ultrasound. USE is a well-established technique in non-gynecological pathology, but it has not yet been endorsed by international gynecological ultrasound guidelines. Although large prospective data are lacking, recent reports suggested its diagnostic benefit in pelvic scanning. In this mini review, we present an overview of the current gynecological use of the technique and provide a graphic overview of the use of elastography in the sonographic evaluation of the uterus and endometrium.