Sonography is a valuable method for the detection of rotator cuff tears. A high resolution transducer and an experienced examiner are necessary. The rotator cuff is not visible in large tears and has a convex outer border in small tears. Sonography reveals pathology of the subacromial bursa, joint effusions, inflammatory tissue in rheumatoid arthritis and often also bony erosions and tendon calcifications. Arthrography is still indicated in equivocal cases. Arthro-CT is the method of choice for the diagnosis of limbus and capsular pathology, but not for rotator cuff tears. MRI shows promising results in rotator cuff tears, but its role has not been definitively assessed.