Objective：To explore the application value of real-time shear wave elastography（SWE） in diagnosing and staging of nonal－coholic fatty liver disease（NAFLD）. Methods：A total of 135 patients diagnosed with nonalcoholic fatty liver disease pathologically or operatively were enrolled to undergo SWE before surgery，and the means of Young’s modulus（Mean） were acquired. The correlation between stages of NAFLD and the Means was analyzed，and the Means of patients at different stages were compared. Finally the receiver operating characteristic（ROC） curve was conducted to evaluate the efficiency of Mean for diagnosing NAFLD at all stages. Results：There were significant differences among Means of NAFLD at different stages（P<0.05），and the Spearman correlation coeffi－cience between Mean and the stage of NAFLD was 0.916（P<0.05）. The area under ROC curve（AUC） of nonalcoholic steatohep－atitis was 0.971（95%CI=0.949 to 0.994），with the sensitivity of 91.3%，the specificity 97.0%，and the threshold value 7.30 kPa. The AUC of fibrosis was 0.984（95%CI=0.969 to 0.999），with the sensitivity of 98.6%，the specificity 88.7%，and the threshold value 9.05 kPa. And the AUC of cirrhosis was 0.965（95%CI=0.940 to 0.990），with the sensitivity of 90.0%，the specificity 88.5%，and the threshold value 11.35 kPa. Conclusion：The Mean of real-time SWE can reflect the severity of NAFLD and is a sensitive indi－cator for NAFLD stages. Consequently it is beneficial to apply SWE in clinical diagnosis and treatment for NAFLD.