OBJECTIVE To evaluate the capability of color Doppler ultrasonography to differentiate between benign and malignant soft-tissue tumors. METHODS We reviewed the ultrasonographic (US) and color Doppler (CD) findings in 46 consecutive patients with a palpable periskeletal mass. The presence of 3 or more vascular hila and of tortuous and irregular internal vessels within the lesions was considered an indication of malignancy. The CD diagnosis was compared with that obtained at US alone. RESULTS The sensitivity and specificity of CD were respectively 85% and 92%; these values were higher than those obtained at US alone, respectively 75% and 50%. Arteriovenous malformations presented as lesions with large internal vessels that had low vascular impedance and were easily diagnosed. The wave form patterns within solid tumors were not specific. CONCLUSIONS At present, US is commonly employed to confirm the presence of a suspected soft-tissue mass, to locate it accurately, and to indicate its nature. CD finding enhance the role of the US technique in such lesions. The combined use of US and CD can allow the differentiation of benign from malignant lesions, and thus provide a better basis for treatment.