The water-sediment interface is highly susceptible to physical, biological, and chemical processes, which can create significant levels of heterogeneity in sediment biogeoacoustic properties at various spatial scales that affect transmission and scattering of elastic waves. Using a suite of microscopy, spectroscopy, and medical sonoelastography techniques, relationships between heterogeneity in the sediment microfabric and shear wave speed can be investigated at spatial scales ranging from centimeters to micrometers. Here, we study fine-grained sediments extracted from two unique intertidal mudflats in the Great Bay Estuary, New Hampshire, USA. Shear waves were excited via acoustic radiation force and external vibration in the 50–200 Hz frequency band, and particle velocity was sensed in the top 2 centimeters of sediment at approximately 0.5-micrometer spatial resolution using a research-grade medical imaging array. By directly imaging the propagating shear wave, spatial heterogeneity of shear wave speed was directly measured. Next, subsamples were extracted and prepared for microscopy, where volume fraction and orientation of organic, mineral, and aqueous components were studied at various spatial scales. A comparison of between shear wave speed and microfabric parameters will be presented. [Work sponsored by ONR.]