Abstract： Objective:To quantitatively analyze the hardness of anal sphincter complex(ASC)in healthy adult women of different ages by real-time shear wave elastography(SWE),and to lay a foundation for future evaluation of ASC lesions.Methods:A total of 124 healthy women who underwent pelvic floor and transvaginal ultrasonography in the Affiliated Hospital of Yunnan University from October 2022 to September 2023 were selected and divided into 4 groups according to age.The thickness of ASC was measured by two-dimensional ultrasound,and the average elastic modulus of ASC was measured by SWE.The thickness and elastic modulus of ASC at different ages were compared and the differences between them were an-alyzed.Results:The internal anal sphincter thicknesses of the proximal plane at 9,12,3,6 points,central plane at 9,12,3,6 points and distal plane at 9,3,6 points were positively correlated with age(rp=0.279,0.298,0.251,0.321,0.247,0.294,0.311,0.399,0.193,0.218,0.251,P＜0.01).The thicknesses of the distal plane of the external anal sphincter at 9,3 and 6 points were positively correlated with age(rp=0.202,0.232,0.305,P＜0.05).The elastic values of the internal anal sphincter of proximal plane at 9,12,3,6 points,central plane at 9,12,3,6 points and distal plane at 9,12,3 points were negatively correlated with age(rp=-0.339,-0.157,-0.466,-0.554,-0.413,-0.183,-0.438,-0.548,-0.403,-0.291,-0.465,-0.509,P＜0.01).The elastic values at 9,12,3 and 6 points of the distal plane of the external anal sphincter were negatively correlated with age(rp=-0.422,-0.317,-0.450,-0.540,P＜0.01).The elasticity of bilateral puborectal muscle was negatively correlated with age(rp=-0.397,-0.450,P＜0.01).Conclusion:Perineal high frequency ultrasound can clearly show the structure of ASC,and SWE technique can quantitatively evaluate the hardness of ASC,which provides an important reference for clinical.