This case report demonstrates the ultrasound appearance of synovial osteochondromatosis of the shoulder, along with plain film radiographic, computed tomographic, and pathologic correlation. Because of recent renewed interest in the use of ultrasonography in the evaluation of musculoskeletal disease, such as rotator cuff arthropathy or suspected intra-articular loose body, opportunities to diagnose synovial osteochondromatosis with this modality have become more frequent.