Objective：To explore the correlation and predictive value of shear wave elastography（SWE）of the rectus femoris with postoperative pulmonary complication（PPC）following thoracoscopic surgery. Methods：Clinical data from 292 patients scheduled for elective thoracoscopic surgery were collected. Patients were divided into the PPC group and the non-PPC group，based on the ocurrence of PPC postoperatively. Preoperative assessments of the rectus femoris included conventional ultrasound combined with SWE， measuring rectus femoris thickness（RF_thick），cross-sectional area（RF_csa），and mean share wave velocity（CS_mean）. Differences in clinical data and the rectus femoris ultrasound parameters between the two groups were compared. The correlation with PPC occurrence was analyzed，and a combined diagnostic formula was derived using binary logistic regression analysis. ROC curves were plotted to further analyze the predictive value of single and combined indicators for PPC. Results：The occurrence of PPCs was positively correlated with age and negatively correlated with the rectus femoris CS_mean（P ＜ 0.001）. Age and CS_mean alone had lower predictive efficacy for PPCs， while their combination showed higher efficacy，with the area under cure of 0.714. Conclusion：Analysis of the rectus femoris CS_mean is feasible for predicting the occurrence of PPCs，and its predictive value is enhanced when combined with age. This non -invasive and rapid assessment can evaluate the risk of PPC in patients undergoing thoracoscopic surgery.