〔Abstract〕 Objective To evaluate the predictive value of ultrasound elastography for breast cancer axillary lymph node metastasis. Methods 68 patients with suspected breast cancer axillary lymph node metastasis admitted to Jiangmen Maternity and Child Health Care Hospital from May 2019 to August 2021 were selected as the research objects. All patients were examined by conventional ultrasound and ultrasound elastography. Pathological examination was used as the gold standard to evaluate the predictive value of ultrasound elastography. Results 68 suspected patients were examined by pathology and 58 were diagnosed with the disease. with routine ultrasound examination, 68 patients were examined with 42 cases of breast cancer axillary lymph node metastasis, and 40 cases were diagnosed; 49 cases were diagnosed by ultrasound elastography, and 48 cases were diagnosed; 57 cases were diagnosed by combination of conventional ultrasound and ultrasound elastography, and 56 cases were diagnosed. The diagnostic detection rate, accuracy, sensitivity and specificity of combined examination of conventional ultrasound and ultrasound elastography were higher than those of single examination, and the differences were statistically significant (P < 0.05). Conclusion In evaluating the diagnosis of breast cancer axillary lymph node metastasis, ultrasound elastography has a certain predictive value. If combining with conventional ultrasound in this process, the diagnostic coincidence rate and sensitivity can be improved.