Objective To analyze the value of high resolution MRI (HRMRI) in the diagnosis of carotid plaque in patients with recurrent cerebral infarction. Methods A total of 262 patients with cerebral infarction who were treated in the hospital from April 2015 to April 2018 were selected as the subjects. Among them, patients with recurrent cerebral infarction were included in the study group (n=162, 165 plaques) and patients with primary cerebral infarction were included in the control group (n=100, 105 plaques). All patients underwent HRMRI within 1 week after onset, and images of 3D-TOF, highresolution MRI black blood sequence and CE-T1WI sequence were obtained. The images were compared between the two groups, and with results of ultramicro blood flow imaging examination as the standard, the efficiency of HRMRI in the diagnosis of vulnerable carotid plaque was analyzed. Results The detection rate of unstable plaques by HRMRI in the study group was significantly higher than that in the control group (41.82% vs 28.57%) (P<0.05). The normalized wall index (NWI), incidence rates of intra-plaque hemorrhage (IPH) and fibrous cap rupture in the study group were higher than those in the control group (P<0.05). With results of ultramicro blood flow imaging examination as the standard, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and kappa consistency of HRMRI in the diagnosis of vulnerable carotid plaque in patients with recurrent cerebral infarction were 95.35%, 85.33%, 88.52%, 75.23%, 97.52% and 0.753, respectively. Conclusion HRMRI can better evaluate the nature of carotid plaques and the state of vascular stenosis in patients with recurrent cerebral infarction and detect vulnerable plaques.