Objective:To explore the relationship of heel fat pad thickness and elasticity with plantar heel pain(PHP) in middle and old aged persons. Methods: Fifty-three orthopaedic outpatients with plantar heel pain were examined by ultrasound to obtain the heel pad thickness in loaded and unloaded condition and figure out the elastic index. Cases were matched with control group of 60 subjects accoraing to body weight index and age. Results: The results demonstrated a significant difference in heel pad thickness between the PHP and control group in loaded and unloaded condition( P <0.05). There was no significant difference in heel pad elastic index and body mass index between the two groups. Conclusions: Body weight index and heel fat pad elastic index have no correlation with PHP in adults. Instead, heel pad thickness has been related to the development of PHP.