Aim. In this prospective observational study, the clinical and morphological changes in lower limb tendons (patellar, quadriceps, and Achilles) were compared in elite fencers. Methods. The study population was 35 elite fencers (14 males and 21 females) proficient in three fencing styles (foil, sabre, epee) who underwent clinical and echographic assessment in March 2007 (baseline) and in April 2010 (follow-up). Spontaneous pain or pain on limb movement and on finger pressure were evaluated by bilateral palpation of the tendons. Tendon thickness and changes in tendon morphology were evaluated by echography. Results. No statistically significant difference in tendon thickness was found between symptomatic and asymptomatic subjects when stratified by sex (Student's t test for unpaired data) or between tendon thickness measured at baseline and at follow-up (Student's t test for paired data). Conclusion. Echography was not predictive for the potential development of clinical symptoms in this sample; however, its use also in asymptomatic subjects did provide information on tendon anatomy which could inform more suitable training methodologies on the strip and off.