Objective: The present study evaluates the association between quantitative indices derived from shear wave elastography and the international normalized ratio-to-platelet ratio (INPR) among patients with depression accompanied by non-alcoholic fatty liver disease (NAFLD). Methods: The study population comprised 120 patients with depression and NAFLD, who were stratified into three equal groups (n=40 per group) based on depression severity: mild, moderate, and severe. The receiver operating characteristic (ROC) curves were used to evaluate the efficacy of the two indicators used alone and in combination for diagnosing liver fibrosis, and the areas under the curve (AUC) were calculated. Results: There were statistically significant differences in the hardness value measured by SWE and INPR among the three groups (P<0.05). Pearson"s analysis showed that SWE hardness values and INPR values were significantly and positively correlated with the patients" level of depression (r=0.714, 0.677, both P<0.001); SWE hardness values were positively correlated with INPR values (r=0.546, P<0.001). ROC curve analysis showed that the AUCs of hardness value measured by SWE and INPR for diagnosing liver fibrosis were 0.797 and 0.776, respectively. The AUC of combined diagnosis with the two was 0.986(Z=3.812、4.168，P＜0.001). Conclusion: The quantitative detection by SWE is significantly correlated with INPR in patients with depression and NAFLD. Combination of the two can achieve higher diagnostic efficacy, providing new evidence for non-invasive diagnosis of liver fibrosis in clinical practice.