This paper presents a fast image synthesis procedure for elastic volumes under deformation. Given the node displacements of a mesh and the 3D image voxel data of an undeformed volume, the method maps the image plane pixels to be synthesized from the deformed configuration back to the nominal pre-deformed configuration, where the pixel intensities are obtained easily through interpolation in the regular-grid structure of the voxel volume. For smooth interpolation, this mapping requires the identification of the mesh element enclosing each image pixel. To accelerate this point location procedure, a fast method of marking the image pixels is employed by finding the intersection of the mesh and the image, and marking this intersection on the image pixels using Bresenham’s line drawing algorithm. A deformable tissue phantom was constructed, it was modeled using the finite element method, and its 3D ultrasound volume was acquired in its undeformed state. Actual B-mode images of the phantom under deformation by the ultrasound probe were then compared with the corresponding synthesized images simulated for the same deformations. Results show that realistic images can be synthesized in real-time using the proposed technique.