Objective: To use shear wave elastography (SWE) to evaluate the changes in the thickness and diameter of the four extraocular muscles and the average Young''s modulus (Emean) in thyroid-associated ophthalmopathy (TAO), and to explore its diagnostic value for TAO . Methods: Randomly collected 60 TAO patients hospitalized in the Department of Endocrinology, Second Hospital of Lanzhou University, and divided them into two subgroups according to the TAO grading standard of the European Research Society in 2008: Group A (TAO edema) 38 cases and Group B (TAO) Fibrosis stage) 22 cases, and 50 healthy volunteers matching age and sex as the control group. High-frequency ultrasound was used to measure the thickness and diameter of extraocular muscles, SWE was used to measure the average Young''s modulus (Emean) of extraocular muscles, and the receiver operating characteristic (ROC) curve was drawn based on the grading assessment results of thyroid-related ophthalmopathy to determine the diagnosis of TAO Cutoff point value. Results: The thickness and Emean value of extraocular muscles in the TAO group were higher than those in the control group (P<0.05). The Emean values of the four extraocular muscles in the control group, A group, and B group gradually increased (P<0.05), and there was no significant difference in thickness and diameter of the TAO subgroups (group A, group B) (P>0.05). The ROC curve shows that the cut-off points of the superior rectus, inferior rectus, external rectus, and medial rectus Emean values for diagnosis of TAO are 9.85kPa, 9.65kPa, 9.85kPa, 9.65kPa, respectively, and the area under the curve is 0.937, 0.922, 0.94, respectively , 0.94; sensitivities were 86%, 78%, 82%, 80%, and specificities were 90%, 95%, 95%, 98.3%.Conclusion: SWE can quantitatively assess the elasticity of extraocular muscles to provide a reference for clinical diagnosis of extraocular muscle diseases in thyroid-related ophthalmopathy.