Elastofibroma dorsi is a rare benign unencapsulated tumour characterized by a elastic fibres proliferation in a collagen stroma with adipose tissue. Lesion is often asymptomatic, monolateral and localized at the tip of the scapular. It is slow-growing. It mainly occurs in adult females. At now some controversies concerning diagnosis and modality of treatment are reported in the literature. Authors report clinicopathological features of elastofibroma dorsi analysing 8 cases from 2001 to 2005, and revise the literature. Seven females and 1 adult male were observed, often dedicated to manual labour. Six symptomatic patients underwent marginal excision of tumour, and the remaining asymptomatic 2 patients were only followed. No local recurrences were observed in operated patients. On the basis of these data Authors evidenced limits of different instrumental methodologies of diagnosis (ultasonography, computer tomography and magnetic resonance imaging) and suggested a algorithm for diagnosis and treatment remarking that marginal excision constitutes effective treatment of symptomatic patients.