Objective To analyze the feasibility of shear wave elastography in evaluating carotid artery stiffness in patients with acute ischemic stroke. Methods One hundred and fifty-three patients with acute ischemic stroke were involved as the observation group. One hundred and fifty healthy volunteers were involved as the control group. General information were collected from all subjects. Carotid pulse wave velocity (PWV) measured by ultrasound. The average values of longitudinal average elastic modulus (MEmean), the maximum elastic modulus (MEmax ) and minimum elastic modulus (MEmin ) were calculated by SWE of bilateral carotid artery. The related indexes of two groups were analyzed. The correlation between PWV and MEmean was analyzed. The ROC curve was used to evaluate the prognostic value of PWV and MEmean in patients with acute ischemic stroke. Results Compared with the control group, the Body mass index (BMI), systolic blood pressure, diastolic blood pressure, glycerol three fat (TG), low density lipoprotein (LDL-C), fasting plasma glucose, carotid artery medial thickness (CIMT), vascular elasticity coefficient (EP), PWV, MEmean, MEmax value and the number of patients with hypertension, diabetic patients of observation group were significantly increased, while the high density lipoprotein (HDL-C), vascular compliance (AC) value of observation group were decreased, the differences were statistically significant(P<0.05).PWV was positively correlated with MEmean (r=0.652,0.557, p=0.000,0.000).The area under the ROC curve and P value of PWV and MEmean predict of acute ischemic stroke were AUC=0.846,P=0.000; AUC=0.805, P=0.000.Conclusion SWE can be used to evaluate carotid artery stiffness in patients with acute ischemic stroke, and it has some predictive value for acute ischemic stroke.