Objective: In this study, we assessed the stiffness of homogeneous carotid plaques using quantitative measurements with shear wave elastography (SWE) and to evaluate its reproducibility. Methods: 199 participants (105 males and 94 females, median age 66±11 years old) underwent gray scale and SWE imaging. Gray scale images’ features and assessments were recorded. SWE imaging was used to acquire cine-loop data and quantify Young’s modulus. The inter-class correlation coefficient (ICC) was calculated to quantify reproducibility of measurements made by the two observers across the three acquisitions. Results: A total of 277 homogeneous carotid plaques (140 hyperechoic and 137 hypoechoic carotid plaques) were performed. Inter-operator reproducibility of stiffness values measured showed an excellent reliability with an ICC of 0.95 for mean stiffness value, 0.92 for minimum stiffness value, and 0.92 for maximum stiffness value. In hyperechoic carotid plaques, the peak middle part showed higher stiffness value as compared to the proximal or distal shoulder part of the plaques (all P<0.05). In hypoechoic plaques, the stiffness values peaked at the basal middle site (all P<0.05, with respect to the top, the proximal and distal shoulder), and bottomed at the peak middle site (all P<0.05). Statistically significant differences with respect to the mean, minimum and maximum stiffness values measured at the proximal, distal shoulder, and the peak middle part of the plaques were found between hyperechoic and hypoechoic plaques (all P<0.01). In both types of plaques, hypertension complicated by hyperlipidemia (P<0.05) and hyperlipidemia alone (P<0.05) were related to lower stiffness values. Hypertension alone was also related with lower stiffness values in hypoechoic plaques (all P<0.05). Conclusions: SWE imaging is a new noninvasive, reproducible and reliable imaging method for the assessment of carotid plaque, which can reflect the stiffness of the plaque and provide additional information for the quantitative assessment of carotid plaques. © 2016, E-Century Publishing Corporation. All rights reserved.