Objective: To explore the diagnostic value of contrast-enhanced ultrasound combined with shear wave elastography in the diagnosis of benign and malignant nodules in the liver parenchyma under the background of liver cirrhosis. Methods: The clinical data of 92 patients with liver cirrhosis and intrahepatic nodules in our hospital from January 2019 to February 2021 were selected and divided into malignant group (52 cases) and benign group (40 cases) based on the pathological results. All patients underwent CEUS and SWE examinations before surgery to compare the differences in parameters between the two groups, and analyze the value of CEUS and SWE alone or in combination in the diagnosis of malignant nodules. Results: The CEUS characteristics of intrahepatic nodules in the arterial phase, portal phase, and delayed phase were statistically different between the malignant group and the benign group (P<0.05), and most of the intrahepatic nodules in the malignant group showed "fast-forwarding fast" The benign group mostly showed the performance of "slow in and slow out". The maximum Young""s modulus (Emax) of nodules in the liver parenchyma in the malignant group was (42.36±5.37) kPa, while that of the benign group was (36.49±6.12) kPa, and the difference between the two groups was statistically significant (P< 0.05). Compared with the separate diagnosis of CEUS and SWE, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of combined CEUS and SWE in the diagnosis of malignant nodules were the highest, and the difference was statistically significant (P<0.05). Conclusion: CEUS combined with SWE can help to improve the differential diagnosis value of benign and malignant liver parenchyma under the background of liver cirrhosis, and has certain guiding significance for the selection of clinical treatment plan.