Objective: To evaluate the diagnostic value of real-time shear wave elastography combined with transvaginal two-dimensional ultrasound in cervical cancer. Method: Ninety-four patients who underwent cervical cancer screening in our hospital from January 2022 to August 2024 were selected as the study objects. All patients underwent transvaginal two-dimensional ultrasound and real-time shear-wave elastography respectively. Using pathological diagnosis as the gold standard for cervical cancer diagnosis, the results of real-time shear-wave elastography, transvaginal two-dimensional ultrasound alone and combined diagnosis of cervical cancer were analyzed and compared. To analyze and compare the diagnostic value of real-time shear wave elastography, transvaginal two-dimensional ultrasound alone and combined in cervical cancer. Results: The pathological examination showed that 58 of the 94 patients were diagnosed with cervical cancer, accounting for 61.70%. There were 20 cases of cervical epithelial neoplasia, 16 cases of normal cervix, 36 cases of non-cervical cancer, accounting for 38.30%. Pathological examination results were taken as the gold standard. According to the Kappa consistency measure, the results of real-time shear wave elastography and transvaginal two-dimensional ultrasound in the diagnosis of cervical cancer were generally consistent with the results of pathological examination (Kappa=0.712, 0.674, P < 0.001). The results of the combined diagnosis of cervical cancer were consistent with the results of pathological examination (Kappa=0.862, P < 0.001). The sensitivity of real-time shear-wave elastic imaging and transvaginal two-dimensional ultrasound combined in the diagnosis of cervical cancer was significantly higher than that of single detection (P < 0.05). However, there were no significant differences between the accuracy and specificity of the combined examination and that of the single examination (P > 0.05). Conclusion: Real-time shear wave elastic imaging combined with transvaginal two-dimensional ultrasound in the diagnosis of cervical cancer has high accuracy, good consistency with pathological diagnosis results, and high sensitivity of combined diagnosis, and has high diagnostic value.