The aim of the study was to investigate the efficacy of shear-wave elastography (SWE) in the differentiation of transudative and exudative pleural effusions. This monocentric study comprised 60 cases (17 transudative, 43 exudative).Transthoracic SWE was performed in 60 cases for whom to use thoracentesis for the pleural fluid analysis was planned. The mean SWE values of each patient were recorded, and the correlation between the biochemical analysis results of pleural fluid after thoracentesis and SWE findings was evaluated. The effusion SWE values and biochemical analysis results were compared. Of the 60 patients who participated in this study, 32 (53.4) were male and 28 (46.6%) were female. The mean +/- SD age was 59 +/- 17.09 years (range = 21-89 years). Simultaneous serum biochemical analysis was performed for the patients with PE. The mean +/- SD shear-wave velocity value of the transudative fluid was calculated 2.29 +/- 0.41 (1.6-2.94), whereas the mean +/- SD shear-wave velocity value of the exudative pleural fluid was calculated as 3.29 +/- 0.63 (2.01-4.88) (P < 0.001). The receiver operating characteristic analysis showed that sensitivity and specificity were found as 91% and 76.5%, respectively, when the cutoff value was selected as 2.52 m/s in the differentiation of the transudative and exudative effusions. Shear-wave elastography may help in the differentiation of transudative and exudative of the pleural effusions.