Four cases of elastofibroma located in the subscapular region of 3 men aged 66, 74, and 83 years, and a woman 70 years old are reported. A correlated light and electron microscopic study including ultrastructural examination of Verhoeff's iron-hematoxylin (VIH)-stained sections was performed. Light microscopically, the elastofibromas were characterized by connective tissue built up by collagen fibers and sclerotic masses mingled with numerous fibers and globules of elastin material. In one micron thick Epon sections these elastin fibers often revealed a central axis surrounded by a mantle composed of periodic segments giving them a necklace-like appearance. The ultrastructural findings of these elastin structures, stained with VIH, and the appearance of the stroma cells and their relation to the elastin indicate that elastofibroma is a non-neoplastic reactive lesion in which elastin material is synthesized by the stromal cells and predominantly laid down around preexisting elastic fibers.