To study the diagnostic value of ultrasound shear wave elastography (SWE) combined with conventional four-dimensional pelvic floor ultrasound for the pelvic floor dysfunction of patients. Methods: The clinical data of 80 patients who had undergone the pelvic floor ultrasound examination from December 2020 to December 2023 were collected. All the patients were given conventional four-dimensional pelvic floor ultrasound examination and SWE examination. The occurrence of the pelvic floor dysfunction of these patients was counted. According to whether the pelvic floor dysfunction occurred or not, these patients were divided into group A (patients with pelvic floor dysfunction) and group B (patients without pelvic floor dysfunction). The values of the conventional fourdimensional pelvic floor ultrasound and SWE indicators of the patients were compared between the two groups. Receiver operating characteristic (ROC) curve was used to analyze the application value of SWE combined with the conventional four-dimensional pelvic floor ultrasound for diagnosing the pelvic floor dysfunction of the patients. Results: There were 19 of 80 patients with pelvic floor dysfunction, with a total incidence of 23.8%. The cervix orifice distance (COD) (9.85±2.05 mm) and the bladder neck descent (BND) (22.68±4.01 mm) under the maximum Valsalva state of the patients in group A were significantly greater than those (5.91±1.62 mm and 19.75±3.99 mm) of the patients in group B (P<0.05). The Young’s modulus value of right puborectalis (PR) of the patients (35.74±5.32 kPa) under the resting state of the patients in group A was significantly higher than that (19.91±3.07 kPa) of the patients in group B, and the Young’s modulus value of right PR (36.10±4.36 kPa) of the patients in group A under the maximum Valsalva state was significantly lower than that (39.92±4.51 kPa) of the patients in group B (all P<0.05). The area under the curve, the sensitivity and the specificity of the combined detections of the values COD, BND, the right PR Young’s modulus under the resting state and the right PR Young’s modulus under the maximum Valsalva state of the patients for diagnosing their pelvic floor dysfunction were 0.986, 94.7% and 73.8%, respectively, and which were significantly higher than those of the single detection (P<0.05). Conclusion: SWE combined with conventional four-dimensional pelvic floor ultrasound for diagnosing the pelvic floor dysfunction of the female patients has high application value, which can provide reference for the early clinical diagnosis of pelvic floor dysfunction of the patients.