Objective To explore the value of color Doppler ultrasound (CDUS) and CT angiography (CTA) in evaluating carotid atherosclerotic plaques in patients with ischemic cerebrovascular disease. Methods 130 patients with suspected ischemic cerebrovascular disease who were treated in the department of neurology of our hospital from June 2014 to June 2017 were selected, and they were examined with CDUS and CTA. The two examination methods were compared in terms of the number of carotid plaques and detection of vulnerable plaques. Results There were a total of 260 common carotid arteries (CCA) with plaques, CDUS detected 517 calcified plaques, 250 soft plaques and 322mixed plaques while the numbers of corresponding plaques detected by CTA were 504, 244 and 341 respectively. There were a total of 260 internal carotid arteries (ICA) with plaques, CDUS detected 85 calcified plaques, 13 soft plaques and 23 mixed plaques while the numbers of corresponding plaques detected by CTA were 228, 104 and 85 respectively. There were a total of 260 external carotid arteries (ECA) with plaques, CDUS detected 39 calcified plaques, 10 soft plaques and 16 mixed plaques while the numbers of corresponding plaques detected by CTA were 42, 20 and 23 respectively. The detection rate of vulnerable plaques in CCA by ultrasound (53.17%) was significantly higher than that by CTA (22.41%). Conclusion CDUS and CTA have their own advantages and disadvantages in evaluating carotid atherosclerotic plaques in patients with ischemic cerebrovascular disease. The combined use of them can help to improve the accuracy of evaluation.