Objective To analyze the correlation between MRI high-signal vascular signs (HVS) and degree of internal carotid artery stenosis in patients with acute cerebral infarction (ACI). Methods A total of 277 cases of ACI patients admitted to our hospital from November 2015 to October 2017 were selected and were examined by CTA of intracranial and cervical arteries. According to the results of examination, the patients were divided into the internal carotid artery stenosis group and the non internal carotid artery stenosis group, and they were given cranial MRI examination, and the positive rate of HVS was compared between the two groups. The stenosis degree of the internal carotid artery stenosis group was divided into different grades. The correlation between HVS positive rate, HVS grade and degree of internal carotid artery stenosis was analyzed by Spearman correlation analysis. Results The positive rate of HVS was 52.43% in the internal carotid artery stenosis group (n=103) and 20.11% in the non internal carotid artery stenosis group (n=174), and the positive rate of HVS in the two groups was significantly different (χ2 =30.978, P<0.05). The HVS positive rate was positively correlated with the degree of internal carotid artery stenosis (r=0.826, P<0.05). The HVS II rate was positively correlated with the degree of internal carotid artery stenosis (r=0.793, P<0.05). Conclusion The MRI HVS positive rate and HVS II rate in ACI patients are positively correlated with the degree of internal carotid artery stenosis, and HVS can evaluate the degree of internal carotid artery stenosis effectively.