Objective To analyze and compare the ultrasound elastography (UE) features of various types of cervical tuberculous lymphadenopathy (CTL), and to investigate the value and limitation of UE in diagnosis of CTL. Methods A total of 70 CTL patients confirmed by pathology or diagnostic treatment who were admitted to Shanghai Pulmonary Hospital affiliated to Tongji University from Jul. 2017 to Mar. 2018 were enrolled, and the images of conventional ultrasound and UE of the largest lymph nodes in each patient were retrospectively analyzed. According to the conventional ultrasound classification criteria of tuberculous lymphadenopathy, the lesions were divided into acute inflammatory type (typeⅠ), caseous necrotic type (typeⅡ), cold abscess type (type Ⅲ) and healing calcification type (type Ⅳ). The elasticity score and strain ratio of various types of CTL lesions were summarized and compared. Results There were 24 (34.29%) typeⅠCTL lesions, 28 (40.00%) typeⅡ, 12 (17.14%) type Ⅲ, and 6 (8.57%) type Ⅳ. The hardness of CTL lesions of typeⅠand typeⅡ was high, with the elastic score being 3-4 (47/52, 90.38%) and the strain ratio being 3-5; the hardness of type Ⅲ was the lowest, with the elastic score being 1-2 (10/12, 83.33%) and the strain ratio<2; the hardness of type Ⅳwas the highest, with the elastic score being 4-5 (6/6, 100.00%) and the strain ratio>5. There were significant differences in elastic score and strain ratio among the four type CTL lesions (H=30.756, F=23.177; both P<0.001). Pairwise comparison showed that except for the differences between typeⅠand typeⅡ lesions, there were significant differences in elastic scores and strain ratios between the four type CTL lesions (P<0.05). Conclusion The value of UE in the diagnosis of CTL is limited. It may play some roles in determining whether there is an obvious granuloma formation in typeⅠlesions and the tension of type Ⅲ lesions.