Objective To explore the value of real-time shear wave elastorgraphy(SWE) in the diagnosis of carpal tunnel syndrome(CTS).Methods 90 patients with CTS and twenty healthy volunteers were enrolled.the median nerves of DW, DF, CSAW, CSAF, WEmean, FEmean,and FRatio were obtained. The differences of parameters between two groups were compared，and the ROC curve was drawn.Results The differences of CSAW,DW,and WEmean were statistically significant between CTS group and control group(P＜0.05). The differences of FEmean,DF,CSAF,and FRatio were no statistically significant(P> 0.05). On ROC curve，the areas under the ROC curve of CSAW, DW, and WEmean was 0.718, 0.654, and 0.942 respectively.WEmean has the best diagnostic efficiency compared to CSAW and DW, and was linearly positively correlated to CSAW.Conclusion SWE imaging can provide the mean elastic modulus of the median nerve,responding the hardness of the median nerve,which provide a non-invasive and simple diagnostic method for CTS diagnosis.