Aim To explore the correlation of high-sensitivity C-reative protein (hs-CRP), fibrinogen(Fg) and the ultrasound indexes of carotid atherosclerosis in acute cerebral infarction. Methods The blood concentration of hs-CRP and Fg were tested while the carotid arteries were examined by color Dopplle and B-ultrasound in 103 subjects which were divided into the following groups: acute cerebral infarction group (ACI, n=33), old cerebral infarction group (OCI, n=34), normal controls (n=36). Results The results showed that the carotid intimal-media thickness (IMT) were significantly increased in all of the diseased groups than those in controls(P all<0.01). The total plaque score(TPS) was thicker in the group of OCI(8.65±5.76 mm)than in the group of ACI (4.68±2.98 mm)(p<0.01) and also in control(3.71±1.35 mm)(p<0.05). The incidence rate of atherosclerous plaque of carotid artery was higher in group of ACI (72.72%) than those in group of OCI (70.59 %)(p<0.05) and control (16.67%) (p<0.05). IMT, TPS and the incidence rate of atherosclerous plaque were different between ACI group and OCI group. The serum concentration of hs-CRP in the groups of ACI (19.54±37.96 mg/L) was higher than that in the group of OCI (4.01±7.22 mg/L)and also in control (1.66±1.17 mg/L) (all p<0.01); there was no difference in the group OCI and control(P>0.05). The 95% confident interval of plasma hs-CRP was 1.24～2.08 mg/L;4.52～34.56 mg/L; 1.42～ 6.62 mg/L respectively in the ACI, OCI and control. Plasma concentration of Fg was not different in the three groups (p>0.05). Multiple regression stepwise analysis revealed that the serum concentration of hs-CRP was positively correlated with the plasma concentration of Fg and TPS; and it was negatively correlated with resistant index. There was negative correlation between the plasma concentration of Fg and high-density lipoprotein cholesterol. Conclusions In the acute phase of cerebral infarction, the change in the plasma of Fg was not sensitive. The concentration of hs-CRP elevated was not correlated with IMT thickening, while closely correlated with the plasma Fg and the total plaque score.