Objective To study the clinical application effects of superb microvascular imaging (SMI) and contrast-enhanced ultrasound (CEUS) in neovascularization of carotid plaques with different thickness. Methods A total of 92 cases of patients with carotid atherosclerotic plaques were selected and given cervical artery Doppler exploration to determine the target plaque, and then they were given SMI and CEUS. Two methods were used to observe the neovascularization in the plaques. Results The severity grading of plaque thickness was increased with the increase of SMI score and CEUS score, and there were statistically significant differences in the severity grading of plaque thickness in patients with different SMI scores and CEUS scores (P<0.05). SMI score was in good consistency with the CEUS score (Kappa=0.475, P<0.05). Conclusion Both of SMI technique and CEUS detection have high diagnostic value in the detection of neovascularization of carotid plaques. SMI technique does not require contrast agent, and has the advantages of non-invasive and low cost, and it can be used as a preferred detection method for detecting neovascularization of carotid plaques.