Ulnar nerve assessment in the cubital tunnel will be explored in detail with an emphasis on assessment of the ìroof and floorî of the cubital tunnel as potential causes of ulnar neuropathy. A new technique for dynamic assessment of the ulnar nerve in the cubital tunnel will be discussed focusing on assessment of not only subluxation but extrinsic compression by the Osborne ligament. Extrinsic compression of the ulnar nerve during flexion results in the ìPacman signî which will be introduced as a new concept in ulnar nerve sonographic dynamic assessment. The concept of applying the median nerve wrist to forearm ratio to the ulnar nerve in the cubital tunnel will also be discussed as a potentially useful measurement parameter.