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Introduction Hoffa's disease is a common condition, and is a severe pathology of the knee joint in many cases. Ultrasound with its capabilities and advantages can be a convenient method of primary diagnosis of this pathology. However, in the literature there is almost no description of the characteristic ultrasound picture of Hoffa’s disease and an analysis of the most common and pathognomonic symptoms. Objective To study ultrasound signs of Hoffa's disease and present the characteristic sonographic complex of its symptoms. Methods Ultrasound examination of the knee joint and arthroscopy of 37 patients diagnosed with Hoffa's disease, confirmed by a comprehensive clinical and instrumental study, was conducted. Results The most characteristic signs of Hoffa's disease in terms of pathological changes are hypertrophy of the Hoffa’s fat pad and changes in its structure, which were detected by ultrasound in 62 % and 84 % of cases, respectively. A new symptom, displacement of the patellar ligament, was identified by ultrasound examination of the knee joint according to the standard protocol in 32 % of the examined. The same percentage comprised the patients who had non-specific sonographic symptoms: an increase in the amount of synovial fluid, as well as signs of infrapatellar bursitis. Ultrasound data were compared with the results of arthroscopic examination, their correspondence was determined. Conclusion It has been established that the ultrasound examination of the knee joint according to the standard method enables to identify a complex of symptoms that are pathognomonic for Hoffa’s disease. It is recommended to introduce it in the protocol of the conclusion.