Aim To investigate the changes of ocular arterial hemodynamics in transient monocular vision loss (TMVL) and the characteristics of internal carotid artery stenosis. Methods Retrospective case control study was adopted. 30 patients’ clinical information diagnosed as TMVL was collected. At the same time, clinical data of normal volunteers was collected as control group. Ultrasonic examination of the ophthalmic artery, central retinal artery and posterior ciliary artery were used to detect peak systolic velocity (PSV), end of diastolic velocity (EDV), resistance index (RI) and pulsatility index(PI). Head and neck CTA was used to examine the stenosis of intracranial internal carotid artery. Results PSV of the ophthalmic artery was significantly decreased in TMVL group compared with the control group (28.40±3.69 cm/s vs 32.58±2.75 cm/s, P=0.000), EDV was significantly decreased in TMVL group compared with the control group (6.10±1.70 cm/s vs 7.35±1.49 cm/s, P=0.001). PSV of the central retinal artery was significantly decreased in TMVL group compared with the control group(8.38±1.68 cm/s vs 9.92±2.30 cm/s, P=0.005), EDV was significantly decreased in TMVL group compared with the control group(2.35±0.80 cm/s vs 2.88±0.62 cm/s, P=0.007). PSV of the posterior ciliary artery was significantly decreased in TMVL group compared with the control group(10.01±2.25 cm/s vs 11.43±1.69 cm/s, P=0.008),EDV was significantly decreased in TMVL group compared with the control group(3.30±1.16 cm/s vs 4.14±1.06 cm/s, P=0.006). There was no significant difference in the RI and PI of the TMVL group in the ophthalmic artery, the central retinal artery and the posterior ciliary artery, compared with the normal control group. The proportion of patients with moderate or severe stenosis of internal carotid artery was significantly higher in TMVL group than that of control group (63.33% vs 10.00%,P=0.000). Conclusion The ocular blood flow is significantly lower in TMVL group than that of the control group. The probability of carotid stenosis is significantly higher in TMVL group than that of the control group.