The film’s sound design, by Leslie Shatz, is of a piece with the film’s subtlety and restraint.

Music is used sparingly. There are a few passages scored to Beethoven’s "Für Elise" and Piano Symphonies Nos. 14 & 2. Like so much in Elephant, that music was an element contributed by a student actor, in this case Alex Frost. Van Sant recalls, "Alex was next to a piano and he started playing. We were going to shoot his bedroom scene the next day and so I said, ‘We should probably have a piano in there.’ Once we did that and shot a scene where Alex does play, that started to suggest using the music in other places in the film."

Much of the film’s sound design is comprised of musique concrète, a form of electronic music developed in the late-1940s and based on natural sounds rather than conventional instruments. Observes Wolf, "It’s not a traditional sound design where it’s wall-to-wall sound, or wall-to-wall music. Just like the film itself, it’s about getting rid of artifice; you’re not telling people how to feel or what to think with your music and sound."