Objective To analyze the effect of CT angiography (CTA) in evaluation of cerebral hemodynamic changes in patients with cerebral infarction complicated with carotid stenosis. Methods The clinical data of 50 patients with cerebral infarction and carotid stenosis admitted in our hospital between March 2012 and October 2015 were collected. All patients were examined by transcranial Doppler ultrasound (TCD), indicating there were different degrees of stenosis or occlusion. CTA and CT perfusion scan (CTP) were performed after admission. The value of CTA in evaluating the cerebral hemodynamic changes in patients was analyzed. Results There were no significant differences in the hemodynamic parameters of frontal lobe, temporal lobe and basal ganglia between patients in control group, patients with mild stenosis and patients with moderate stenosis (P＞0.05). CBF of frontal lobe, temporal lobe and basal ganglia in patients with severe stenosis or total occlusion were lower than those in control group while CBV, MTT and, TTP and CBF were higher than those in control group (P＜0.05); CTA showed 43 normal branches, 9 branches with mild stenosis, 12 branches with moderate stenosis, 23 branches with severe stenosis, and 13 branches with occlusion. The consistency with the results of TCD was high (P＜0.05). Conclusion CTA combined with CTP examination is helpful to the comprehensive evaluation of cerebral hemodynamic changes in patients with cerebral infarction complicated with carotid stenosis, which can provide imaging guidance for clinical treatment.