We present a detailed scanning tunnelling microscopy study which describes the morphological transition from ripple to dome islands during the growth of Ge on the vicinal Si(1 1 10) surface . Our experimental results show that the shape evolution of Ge islands on this surface is markedly different from that on the flat Si(001) substrate and is accomplished by agglomeration and coalescence of several ripples. By combining first principle calculations with continuum elasticity theory, we provide an accurate explanation of our experimental observations.