Objective To explore value of TCD combined with CTA and CT perfusion imaging in the evaluation of changes of cerebral hemodynamics in patients with carotid artery stenosis or occlusion. Methods 94 patients with carotid artery stenosis or occlusion from April 2013 to October 2015 were selected as the research objects, 94 healthy examinees in our hospital in the same period were selected as the control group, all patients and volunteers underwent TCD combined with CTA and CT perfusion imaging, changes of cerebral hemodynamics of patients in different stenosis degree and the control group. Results Mean blood flow velocity of bilateral arteriae cerebri in patients with mild stenosis, moderate stenosis, severe stenosis and occlusion were (61.09±18.37)cm/ s, (55.26±18.61)cm/s, (47.28±15.96)cm/s, (41.75±16.22)cm/s respectively, which were significantly lower than the control group (69.42±21.55)cm/s (P<0.05). Peak time in patients with mild stenosis, moderate stenosis, severe stenosis and occlusion were (8.24±2.39)s, (9.36±2.54)s, (10.17±2.92)s, (10.94±2.75)s respectively, which were significantly higher than the control group (7.63±2.12)s (P<0.05). Conclusion Carotid artery stenosis or occlusion is closely related to intracranial arterial hemodynamics, opening situation of collateral circulation tube, cerebral perfusion parameters and others, TCD combined with CTA and CT perfusion imaging can comprehensively evaluate changes of cerebral hemodynamics in patients with carotid artery stenosis or occlusion, and provide scientific basis for formulating reasonable and effective treatment plans.