Objective To evaluate the correlation between the geometric shape of the carotid bifurcation angle and the existence of the internal carotid atherosclerotic plaque on multi-slice spiral CT angiography (MSCTA). Methods MSCTA images of fiftyeight subjects from 2012～2013 were analyzed retrospectively, in which images were processed and analyzed with the GE AW4.4 workstation. The geometric shape of the carotid bifurcation angle, the common carotid bifurcation angle (CCBA), the internal carotid bifurcation angle (ICBA) and external carotid bifurcation angle (ECBA), the presence or absence of plaque of the internal carotid and the thickness of plaque at the initial region of the internal carotid artery(ICA), were determined. The geometric shape of the carotid bifurcation angle, CCBA, ICBA, ECBA and normalized ICBA indexes were grouped by the presence or absence of plaque of the internal carotid. The paired T-test or Chi-Square Tests were performed with SPSS version 16.0. Statistical significance was set at P<0.05. Results There was no difference in the presence or absence of plaque of the internal carotid from each aspect between the ICBA and the presence or absence of plaque of the internal carotid (T=-1.244, P=0.219), the ECBA and the plaque (T=- 0.027, p=0.987), the CCBA and the presence or absence of plaque of the internal carotid (T=-0.186, P=0.853), and the normalized internal carotid bifurcation angle index and the presence or absence of plaque of the internal carotid (T=-1.379, P=0.173), the geometric shape of the carotid bifurcation angle and the presence or absence of plaque of the internal carotid (χ2 =0.919, P=0.632). Conclusion The variability between the geometric shape of the carotid bifurcation angle is not associated with the presence or absence of plaque of the internal carotid.