The choice to use MR imaging or ultrasound to depict tendon pathology has traditionally depended on the imager's level of experience and comfort with the modality, and less so the individual strengths of either modality. Although this may be an acceptable rationale, it does not fully take advantage of the strength of either modality or the potential benefits of combining both modalities. This article demonstrates the complementary roles of these two modalities through a variety of clinical examples, based on experience working in a subspecialty hospital dedicated to orthopedic and rheumatologic diseases.