Objective: To investigate the value of hemodynamic parameters of intrarectal ultrasound (ERUS) and shear wave elastography (SWE) in the differential diagnosis and T staging of rectal cancer. Methods: The clinical data of 128 patients with rectal tumors were selected for retrospective analysis. The selection time was from May 2018 to June 2020. A total of 68 cases of rectal cancer (malignant group) and rectal adenoma (benign group) were diagnosed by pathological biopsy. ) A total of 60 cases were examined by ultrasound and shear wave elastography. The hemodynamic parameters such as RI, PI, PSV, EDV and Emean indexes of the malignant group and the benign group were compared; the hemodynamics of different stages of rectal cancer were observed Parameters and Emean value; and to evaluate RI, PI, PSV, EDV, comprehensive hemodynamic parameters, AUC, sensitivity, specificity, and Youden index for the diagnosis of rectal cancer by Emean. Results: The RI and PI of the malignant group were lower than those of the benign group, while PSV, EDV, and Emean were higher than those of the benign group (P<0.05). One-way analysis of variance showed that the differences in RI, PI, PSV, EDV, and Emean in T1, T2, T2, and T4 were statistically significant (P<0.05). ROC curve analysis showed that RI, PI, PSV, EDV, comprehensive parameters of hemodynamics, and AUC for the diagnosis of rectal cancer by Emean were (0.914, 0.747, 0.666, 0.839, 0.999, 0.996, P<0.05); the sensitivity was respectively 88.20%, 48.50%, 72.10%, 64.70%, 98.50%, 100.00%; specificity is 83.30%, 100.00%, 56.70%, 95%, 98.30%, 93.30%. Conclusion: Both ERUS hemodynamic parameters and SWE have high clinical value in the differential diagnosis of rectal cancer. SWE can be used as an auxiliary method of ERUS. The combination of the two can better perform T staging and provide objective clinical diagnosis and treatment. in accordance with.