Objective To detect the morphological and hardness changes of tibia nerve in type 2 diabetes mellitus by high frequency ultrasound probe and shear wave elastography and explore the clinical evaluation value.Methods High frequency ultrasound scan and shear wave elastography were performed in 39 cases of type 2 diabetes mellitus patients with peripheral neuropathy, 35 patients without peripheral neuropathy and 32 healthy volunteers. The cross section area of tibia nerve, the maximum and average value of Young′s modulus were measured, and then the ROC curves were drawn respectively. The diagnostic value of cross section area, the maximum and average value of Young′s modulus was compared, and the cutoff values were calculated. Results The area under the curve of cross section area, the maximum and average value of Young′s modulus was 0.727, 0.878 and 0.872 respectively, and the cutoff values 0.19 cm 2, 60.6 Kpa and 54.5 Kpa respectively. Conclusion Shear wave elastography is effective in the diagnosis of diabetic peripheral neuropathy by energizing the changes of nerve hardness. 