Objective: Exploring the evaluation of shear wave elastography on the changes of muscle elasticity at MTrPs in patients with myofascial pain syndrome and its application in traditional Chinese medicine manipulation. Methods: A retrospective analysis of 60 patients with myofascial pain syndrome in the observation group and 60 healthy persons in the control group who were admitted from June 2018 to April 2020, all underwent real-time shear wave elastography detection, and real-time analysis by ROC curve The diagnostic value of shear wave elastography, and the comparison of Young"s modulus (E), tissue shear wave velocity (SWV), upper trapezius muscle thickness, and visual analog scale (VAS) scores between the two groups. At the same time, patients in the observation group were divided into two groups according to the treatment methods, namely the conventional group (30 groups) and the auxiliary group (30 groups). The pain relief rate and simplified McGill pain (simplified SF-MPQ) score of the two were compared.. Results: The E, SWV, upper trapezius thickness, and VAS scores of the observation group were higher than those of the control group (P<0.05). After ROC curve analysis, SWE"s AUC is 0.948, sensitivity is 95.24, specificity is 94.44, and it has a certain accuracy. When comparing the effects of the two groups at the same time, the pain relief rate of 1 course, 2 courses, and 3 courses of the auxiliary group was significantly higher than that of the conventional group, and the VAS score, PPI score, and PRI score of 15 days after treatment were lower than those of the conventional group (P< 0.05). Conclusion: Shear wave elastography has high specificity and sensitivity in assessing and diagnosing changes in muscle elasticity at MTrPs in patients with myofascial pain syndrome. It is assisted in the treatment of traditional Chinese medicine to better relieve pain.