The objective of this chapter is to cover the strain imaging examination protocol. The patient lies on her back with her ipsilateral hand raised on the examination bed. The medial half of the breast is examined in the supine position. The examination starts after positioning a linear transducer (4–9 MHz), with the B-mode image which depicts the lesion of interest, as elastography images are generated from raw data from B-mode. When an optimal B-mode image is obtained, strain elastography (SE) imaging is activated by using a button on the menu (it depends on the system which is used). The freeze button is pressed after approximately 10 seconds of observing. Subsequently, one region of interest (ROI) is placed in the focal lesion, and the reference ROI is placed in the surrounding normal fat tissue, preferably in the same depth as the lesion. Acquisition tips are also given in this chapter.