It is often difficult to identify the characteristics of soft-tissue tumors of the chest wall. This paper describes the peculiarities of elastofibroma dorsi, a rare pseudotumor of this site, to exclude many dangerous misconceptions. During the period between 1987 and 1997, we treated nine patients with elastofibroma dorsi. In six patients, the lesion was unilateral and in three it was bilateral. All these lesions were excised and no evidence of local recurrence or shoulder disability was observed at the last clinical evaluation. Elastofibroma dorsi is a rare, slow-growing, pseudotumoral lesion of the soft tissues of the chest wall with a peculiar radiographic and histologic pattern.