Objective Discuss the value of SWE quantitative technique in the diagnosis of thyroid benign and malignant nodules and its prediction of invasiveness of malignant nodules. Method A retrospective analysis of 230 patients with thyroid nodules confirmed by surgical pathology and real time shear wave elastography.Draw the ROC curve,To determine the diagnostic value of Young’s modulus for diagnosis of benign and malignant thyroid nodules;Of which 122 cases of thyroid cancer patients according to whether cervical lymph node metastasis and Emax classification, nodule size, age, gender, Emean, and Eratio values were Logistic regression analysis of real-time shear wave elastography Young’s modulus correlation with malignant cervical lymph node metastasis of thyroid nodules. Result 230 cases of benign and malignant thyroid nodules, compared with the whole group, the SWE Young’s modulus of benign nodules group was lower than that of malignant nodules group, except for Emin value difference was not statistically significant (P > 0.05). The difference between the other three groups was statistically significant (P < 0.05). The cut-off values of Emax, Emean and Eratio in diagnosis of benign and malignant thyroid nodules were 57Kpa, 39Kpa and 2.7, respectively. The corresponding area under the curve was 0.877, 0.776, 0.866, respectively. The three cases were diagnosed as benign and malignant thyroid nodules. The value of Emax was the largest in the diagnosis of thyroid nodules under the benign and malignant curves. Malignant thyroid nodules of cervical lymph node metastasis and nodule size, Emax value, Eratio value (P < 0.05), with the Emax value increasing nodule size increased, and Eratio value of the cervical lymph node metastasis in corresponding lymph node metastasis may increase, and most are located in the central area. Conclusion The values of Emax, Emean and Eratio were significant for differentiating benign and malignant thyroid nodules, and Emax value was the highest in differential diagnosis of benign and malignant thyroid nodules. Emax value and Eratio value can be used as predictors of invasion of thyroid malignant nodules. The greater the Emax and Eratio values, the higher the probability of lymph node metastasis, the higher the invasiveness of thyroid malignant nodules.