Objective To investigate the value of ultrasonic elastography in evaluating tumor response to neoadjuvant chemotherapy(NAC) in patients with breast cancer receiving neoadjuvant chemotherapy . Methods The study included 40 breast cancer patients who received NAC and surgical treatment. All of the patients underwent conventional and ultrasound elastic examination before and after NAC. The imagines were analyzed by five-point elasticity scoring system and ultrasonic strain ratio method, and compared with pathological results. Results With the pathological response as gold standard, the low scores group had significantly higher pathological response than the high group(P=0.002), and the accuracy of scoring system in predicting pathologic response was 78.1%. Both the gland-to –lesion strain ratio and of the fat-to-lesion strain ratio lesions showed significantly decrease in pathological response cases than in non-pathological response ones (P=0.001, P=0.005, respectively). The accuracy of the gland-to –lesion strain ratio and of the fat-to-lesion strain ratio were 82.0% and 75.3%. Conclusion Ultrasonic elastography is effecting in assessing and predicting the response of breast cancer patients undergoing NAC.