Objective To explore the value of conventional ultrasound (US) combined with shear wave elastography (SWE) in the differential diagnosis of parotid pleomorphic adenoma and Warthin''s tumor, and compare the diagnostic efficiency with MRI. Methods Select 81 cases of parotid gland tumors confirmed by pathology, 58 cases of pleomorphic adenoma and 23 cases of Warthin''s tumor, Compare the US characteristics of two lesions: Shape, boundary, hyper echo, anechoic, blood flow distribution, blood flow grade and SWE quantitative parameters: Emax, Emean, Emin, SD. Results There were statistical significance in the tumor Shape, hyper echo, anechoic, blood flow distribution, blood flow grade and Emax, Emean, SD between the pleomorphic adenoma and Warthin''s tumor (P＜0.05), The area under the ROC (AUC) of the Logistic equation predicted values of US , SWE and US+SWE are 0.881, 0.837, 0.962. The diagnostic sensitivity, specificity, accuracy of US+SWE and MRI were (85%, 87.27%), (88%, 84%), (86.2%, 86.2%), The difference was not statistically significant (P＞0.05), the diagnostic value is consistent. Conclusions Conventional ultrasound combined with shear wave elastography can improve the ability of differential diagnosis pleomorphic adenoma and Warthin''s tumor of parotid, and the diagnostic efficiency is comparable to MRI.