Abstract: Objective To investigate the value of color image scoring with shear wave elastography in the diagnosis of benign and malignant breast solid lesions.Me thods From February 2016 to February 2017, 125 patients with breast lesions were given shear wave elastography score, by type of image scoring method, image color method for differential diagnosis between benign and malignant lesions. Re s ults Among all the 125 patients with breast solid lesions, 175 were solid lesions, of which 85 cases (119) were benign lesions, accounting for68%, and 40 (56) were malignant lesions, accounting for 32%. The difference of type and color score between benign breast lesions and malignant lesions was statistically significant (P < 0.05) . A positive correlation was fourd between color image type score and color score of benign and malignant breast lesion, using shear wave elastography (P < 0.05) . The pathological findings were used as a gold standard, and the difference in the area under ROC curves of benign and malignant lesions of the breast was statistically significant by using type and color scoring method (P < 0.05) . Type scoring method and color scoring method have higher diagnostic efficacy when the diagnostic value is above 2 points. Conclus ion The shear wave elastography color image scoring method is of high clinical value in the diagnosis of benign and malignant breast solid lesions, and it is of high accuracy for the diagnosis of benign breast solid lesions.