OBJECTIVE: To investigate the relationship and differential efficacy between quantitative parameters of contrast-enhanced ultrasound and shear wave elasto- graphy (SWE), urinary bladder tumor antigen (BTA), and nuclear matrix protein 22 (NMP22). STUDY DESIGN: We selected 87 patients with noninvasive bladder cancer (Noninvasive group) and 87 patients with invasive bladder cancer (Invasive group) from June 2017 to September 2020. The general data, urine BTA and NMP22, and quantitative parameters of contrast ultrasound were compared between the 2 groups, as well as SWE quantitative parameters. TPH, DS, Emax, Emean, and urine BTA and NMP22 were analyzed by Pearson correlation coefficient. Logitic regression equation was used to analyze the influencing factors of invasive bladder cancer. The recognition efficiency was analyzed by receiver operating characteristic (ROC) curve. RESULTS: The urine BTA and NMP22, TPH, Emax and Emean in the Invasive group were higher than those in the Noninvasive group (p<0.05), but DS was lower than in the Noninvasive group (p<0.05). TPH, Emax, and Emean were positively correlated with urine BTA and NMP22, while DS was negatively correlated. The AUC of TPH+DS+Emax+Emean in the identification of invasive bladder was greater than any single parameter. CONCLUSION: The changes of contrast-enhanced ultrasound and SWE quantitative parameters of bladder cancer are related to the levels of urinary BTA and NMP22. Combined examination and clinical evaluation can provide reference information and aid in making a treatment plan. (Anal Quant Cytopathol Histpathol 2021;43:711-717) © Science Printers and Publishers, Inc. © 2021 Science Printers and Publishers Inc.. All rights reserved.