Objective To assess the value of magnetic resonance angiography (MRA) and arterial proton spin labeling (ASL) in the internal carotid artery transient ischemic attack. Methods According to TIA seizure frequency, 58 patients clinical diagnosed as TIA were divided into single group (n=12) and the frequent group (n=46). All patients underwent MRA and ASL, then intracranial arterial stenosis and cerebral perfusion were evaluated. Results Vascular stenosis with abnormal ASL were detected in 33 (71.74%) of 46 frequent TIA patients and 1 (8.33%) single TIA patient. The incidence of vascular stenosis with abnormal ASL was higher in frequent TIA than that in single TIA (P＜0.05). Conclusion Vascular stenosis with perfusion abnormality is one of the most risk factors of TIA frequent seizures. Combination of MRA and ASL can make judgment for stenosis and abnormality of cerebral blood flow, being helpful to understand the onset causes and prognosis of TIA.