Aim To examine the morphological characteristics and the composition of atherosclerotic plaque in carotid arteries using multislice spiral computer tomography(MSCT) and to investigate the relationship between these plaque features and cerebral infarction.Methods The MSCT angiography images of 60 patients with carotid related cerebral infarction were analyzed retrospectively,and the degree of carotid stenosis,plaque components and morphological characteristics was measured using automated plaque analysis software.Results The ratio of moderate and above luminal stenosis(80.0% vs 45.0%,χ2=15.68,P<0.05),the ratio of soft plaques and mixed plaques(68.9% vs 38.3%,χ2=12.54,P<0.05),the ratio of irregular and ulcer plaques(77.0% vs 38.3%,χ2=20.62,P<0.05)was significantly different between infarct side and contralateral side.Conclusion Instable plaque with irregular surface can increase the risk for stroke compared with stable plaque with regular surface in carotid artery.MSCT angiography is an important and non-invasive method for carotid atherosclerotic plaque.