Objective To evaluate the diagnostic accuracy of transcranial doppler(TCD)as an additional screening tool for intracranial arterial steno-occlusive disease in patients with acute ischaemic stroke(AIS)by comparing with the computed tomography angiography(CTA). Methods Two hundred and twenty-four consecutive patients who were hospitalized within 7 days of the onset of symptoms and fulfilled the criteria for the clinical di-agnosis of AIS between May 2013 and May 2014 were enrolled for the study. Among the 224 patients,there were 118 males and 106 females with an average age of 61.2±12.6 years. High-resolution brain CTA was performed after completion of TCD. Results There was slight distinction of the diag-nostic accuracy of TCD for different arteries. TCD demonstrated the most accurate diagnosis for carotid artery vascular system,with a sensitivity of 96.19%and specificity of 98.60%. For the vertebrobasilar vascular system,TCD diagnosis showed a sensitivity of 71.11%and specificity of 94.31%. TCD findings were complementary to the CTA results(real-time embolization,collateral flow patterns and steal phenomenon). Conclusion TCD shows a high diagnostic accuracy comparing to CTA in evaluating intracranial and extracranial arterial stenosis in patients with AIS,especially for the carotid artery vascular system analysis within a short time interval. TCD can also provide additional real-time dynamic findings complementary to the information provided by CTA.