Cell apoptosis plays an important role in cancer therapy and is the main mechanism to kill cancer cells. Assessment of apoptosis helps to estimate the efficacy of drugs and evaluate of tumor response to therapy in early stage. Imaging of apoptosis will greatly improve the ability of understanding the tumor development, guiding the individualized treatment and predicting the outcome. This paper mainly presents the recent progress of ultrasonic imaging in apoptosis and application of early evaluation of tumor response to therapy.