ABSTRACT Objective To investigate the characteristics of long axis shear wave velocity (SWV) values of the quadriceps femoris, the hamstrings and the biceps brachii in patients with sarcopenia and to investigate the value of real-time shear wave elastography (SWE) in assessing muscle status in patients with sarcopenia. Methods 22 patients with sarcopenia (lesion group) and 21 age- and sex-matched healthy subjects (control group) were selected. Shear wave elastography was used to obtain SWV values in the long axis of four quadriceps femoris muscles [vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM) and vastus intermedius (VI)], three hamstrings [biceps femoris (BF), semitendinosus (ST) and semimembranosus (SM)] and biceps brachii (BB) relaxation on the dominant side of the lesion control group, and a comparative analysis was performed. Results There were significant differences in the SWV values of the VL, RF, VM, VI, BF, ST, SM and BB muscles between the lesion group and the control group in the relaxed state (all P <0.001). Compared with the control group in the relaxed state, the SWV values of lesion group of VL, RF, VM, VI, BF, ST, SM and BB muscles were decreased by 7.8%, 7.0%, 7.3%, 7.3%, 7.1%, 7.3%, 6.5% and 6.7%. And the reduction of muscle elasticity in the long axis of SM was the least in the lesion group, while the reduction of muscle elasticity in the long axis of VL was the most significant. In addition, both age and BMI are factors influencing the elastic modulus of skeletal muscle in the elderly. Conclusion The real-time shear wave ultrasound elastography can detect the difference of elastic modulus in skeletal muscle of patients with sarcopenia, and provides a new detection method for assessing the muscle status of sarcopenia patients.