We report herein the successful use of ultrasound therapy in the treatment of hypodermitis sclerodermiformis (HS). It is a skin disease characterized by well-circumscribed, chronic, painful and tender, single or multiple, board-like, indurated, sharply bordered lesions, occurring on the legs of patients with venous insufficiency. Hypodermitis sclerodermiformis is a little-known clinical entity, often undiagnosed or misdiagnosed as phlebitis, cellulitis, or stasis dermatitis. It merits clinical recognition because of the gratifying and unique response it has to treatment with ultrasound therapy.