Rupture of carotid atherosclerotic plaque is one of the important causes of stroke. A large number of studies have confirmed that carotid plaque neovascularization is an important factor leading to intraplaque hemorrhage and rupture. Inflammatory factors and all kinds of cells enter the plaque through intraplaque neovascularization, which leads to the destruction of plaque stability. But the important related factors and main mechanisms affecting the formation of intraplaque neovascularization are not completely clear. Therefore, to identify intraplaque neovascularization and explore the related factors and mechanism of intraplaque neovascularization is the key to study plaque instability caused by intraplaque neovascularization. Inhibition of intraplaque neovascularization may be a new strategy for prevention and treatment of carotid plaque rupture and reduction of cerebral embolism. The purpose of this review is to explore the related factors, mechanism and the latest research progress of detection and imaging of carotid intraplaque neovascularization, so as to provide support for the diagnosis and treatment of clinical diseases.