Abstract: Objective To investigate the diagnostic value of transcranial Doppler ultrasound (TCD) combined with carotid ultrasound in ischemic cerebrovascular disease for clinical reference. Methods Total 739 patients with ischemic cerebrovascular disease in the department of neurology in our hospital were enrolled in the study, who were given TCD, carotid ultrasound and CT angiography (CTA) of head and neck within one week after admission, with the results as the reference for the final diagnosis. The positive rates of TCD combined with carotid ultrasonography and CTA were compared. The positive predictive value, negative predictive value, sensitivity, specificity and accuracy of combined examinations were calculated. Results ① There were no significant difference in the positive rate between TCD combined with carotid ultrasonography and CTA (49.53% vs. 51.69%, χ²=0.693, P=0.405). ② The positive predictive rate of TCD combined with carotid ultrasound was 97.27%, the negative predictive rate was 93.03%, the sensitivity was 93.19%, the specificity was 97.20%, the accuracy was 95.13%, and the Kappa value was 0.903. Conclusion The diagnostic accuracy of TCD combined with carotid ultrasound for ischemic cerebrovascular disease is close to that of head and neck CTA, which is worthy of clinical promotion.