Optoacoustic (OA) imaging in combination with diagnostic pulse-echo ultrasound is most flexibly implemented with irradiation optics and acoustic probe integrated in epi-style in a combined probe. Unfortunately, clinical epi-OA imaging depth is typically limited to one centimetre owing to clutter signals that originates from the site of tissue irradiation. In past years we have developed displacement-compensated averaging (DCA) for clutter reduction, based on the clutter decorrelation that occurs when palpating the tissue using the ultrasound probe. This method has now been implemented on a research ultrasound system for real time scanning with freehand guidance of the linear probe. Volunteer results confirm that clutter is significant in clinical OA imaging, and that DCA significantly improves image contrast as compared to conventional averaging. Clutter reduction is therefore a basic requirement for a successful combination of OA imaging with pulse-echo ultrasound.