Abstract： Objective:To evaluate the abnormal changes in the liver stiffness (LS) in the pregnant women with or without hypertensive disorder of pregnancy (HDP) using conventional ultrasound and two-dimensional shear wave ultrasound elastography (2D-SWE).Methods:A total of 73 pregnant women were enrolled and diagnosed in the Second Affiliated Hospital of Dalian Medical University from May to September 2023. They were divided into pregnant women without HDP (group A, 36 cases), and pregnant women with HDP (group B, 37 cases). Another 36 healthy volunteers were enrolled in the control group (group C). The thickness and length of the left lobe of the liver, the maximum oblique diameter of the right lobe of the liver and the diameter of the main trunk of the portal vein were measured with two-dimensional ultrasound. The velocity of the portal vein was measured with pulse wave Doppler. 2D-SWE technique was used to measure LS (E mean). Parameters were compared among the groups. Results:The right hepatic oblique diameters in groups A and B were larger than those in group C: 13.87 (0.54) cm and 13.95 (0.36) cm vs. 13.56 (1.02) cm (all P<0.01), but there was no significant difference in the right hepatic oblique diameter between group A and group B ( P>0.05). E mean in both group A and group B were greater than those in group C: 5.02 (0.62) kPa and 5.99 (0.31) kPa vs. 4.76 (0.08) kPa ( P<0.01). E mean in group B was greater than that in group A ( P<0.05). Systolic and diastolic blood pressure were independent impact factors of Emean ( P<0.05). E mean and diastolic blood pressure were independent impact factors of HDP ( P<0.05). Conclusions:2D-SWE technique could be used to accurately, objectively and non-invasively evaluate abnormal the changes of liver stiffness in patients with HDP.