Objective To investigate the influencing factors of quality of shear wave elastography (SWE) image and the reproducibility of using SWE for focal liver lesions .Methods A total number of 289 consecutive patients with 305 lesions (the lesions could be detected on baseline ultrasound with intercostals approach ,and the depth of lesion was less than 10 cm) were undergone SWE examination .The SWE values of both lesion and adjacent liver parenchyma were measured .The quality of images was classified into three grades:“Good” ,“Common” ,and “Poor” .The depth of lesion ,the distance from body surface to liver capsule ,diameter and location of lesion were compared among three groups .Twenty consecutive patients with 20 lesions were performed SWE by two operators and another 20 consecutive patients with 20 lesions were performed SWE by one operator at different time .Intra‐class correlation coefficient was used to evaluate the reproducibility of inter‐ and intra‐ observer .Results A total number of 179 lesions were“Good” ,107“Common” and 19 “Poor” .The distance from body surface to liver capsule was significantly different among three groups [(Good (1 3.4 ± 0 3.5)cm ,Common (1 6.3 ± 0 3.6)cm ,Poor (1 8.7 ± 0 3.9)cm , P < 0 0.01] .No significant difference was found for the depth ,diameter and location of lesions among three groups .For all parameters of SWE both lesion and adjacent parenchyma ,intra‐class correlation coefficient of inter‐and intra‐observer were higher than 0 7.5 .The reproducibility of max SWE value was best of four elasticity parameters for lesion ,which intra‐class correlation coefficient of inter‐and intra‐observer was 0 9.0 and 0 9.6 ,respectively .Conclusions For focal liver lesions which could be detected on baseline ultrasound and the depth of lesions was less than 10 cm ,SWE could be used to evaluate elasticity characteristics with good feasibility and reproducibility .