Localized scleroderma (LS) is a chronic disease of the connective tissue without involvement of internal organs. This disease is the topical problem of modern medicine, because it is drug-refractory, causes stable cosmetic defect and, in some cases, the development of functional disorders in the affected area. The success of treatment depends on the quality of diagnosis and individual approach with allowance for the stage, degree of activity, severity, depth of pathological process, and objective assessment of the effectiveness of treatment. The use of high-frequency ultrasound scanning as an auxiliary method facilitates solving this problem. This study was aimed at providing the rationale for the use of high-frequency ultrasound scans to diagnose and monitor the efficacy of treatment. The article presents the results of the study of patients diagnosed with localized scleroderma at different stages of the process (edema, sclerosis, and atrophy) using high-resolution ultrasonic scanning with probe signal frequency of 22 MHz. We describe some applications of this method to monitor the effectiveness of treatment, assess the depth of the pathological process, and facilitate the diagnosis. Conclusion. These results show the feasibility and effectiveness of high-frequency ultrasound scanning in patients with LS in everyday dermatology practice.