Objective To investigate the clinical value of color Doppler ultrasound (CDFI) in the diagnosis of carotid atherosclerosis lesion in patients with acute stroke.Methods Totally 60patients with acute cerebral infarction were examined with CDFI to observe vessel diameter and stenosis degree of common carotid artery,internal carotid artery and external carotid artery and the results were compared with digital subtraction angiography (DSA) test.Results Among 60patients,normal ultrasound diagnosis was in 28 cases,occlusion and stenosis in 32 cases,stenosis in 25 cases; mild,moderate and severe stenosis were in 18,20,12 vessels,occlusion in 7 cases,14vessels.DSA examination results showed normal in 29 cases,stenosis and occlusion in 31 cases,stenosis in 26 cases,mild,moderate and severe stenosis of the 18,16,18 vessels; occlusion in 5 cases,10 vessels.The consistency test results between carotid artery color Doppler ultrasound and DSA were Kappa=0.786,0.667(P＜0.05).All carotid DSA results were considered as gold standard,CDFI diagnosis of moderate to severe stenosis was in high accuracy compared with DSA.Conclusions CDFI in the diagnosis of different degrees of carotid stenosis is in good agreement with DSA diagnosis,and may replace invasive DSA diagnosis of moderate to severe stenosis.