Objective To evaluate the clinical effect of ultrasound shear wave elastography (SWE) on venous malformation sclerosis. Methods 30 patients with venous malformations who were clinically diagnosed and examined by MRI and conventional ultrasound were selected as the study subjects. All the subjects were examined by conventional ultrasound and SWE before, 1 week and 1 month after sclerotherapy to record the relevant parameters. The effect of SWE in the evaluation of venous malformations after sclerosis treatment was discussed for Clinical application value. Results Compared with conventional ultrasound, SWE was more sensitive in evaluating venous malformation after vascular sclerosis treatment. (2) SWE showed that the hardness of venous malformation sclerosis lesions increased in 1 month after treatment, and the hardness ratio of the lesion to surrounding tissues increased. There were significant differences between before and after treatment (P < 0.05). Conclusion SWE can effectively evaluate the clinical efficacy of venous malformation sclerosis after treatment, and has a certain clinical value, and simple operation, easy to implement, it is recommended to adopt.