Abstract: Objective to evaluate the cerebral hemodynamics in patients with unilateral internal carotid artery (ICA) stenosis or occlusion by TCD combined with CT perfusion imaging (CTP). Methods 21 patients with TCD were diagnosed as unilateral ICA stenosis or occlusion of the patients according to their condition, divided into asymptomatic group (11 cases) and symptom group (10 cases), two groups of patients received cranial CTA (angiography) and CTP detection. The reference group was 16 healthy volunteers. The TCD and CTP parameters were compared between the asymptomatic group and the symptomatic group, the symptom group and the control group. Results TCD showed that, in contrast to the reference group, the average blood flow velocity of MCA in the symptomatic group was lower, and the MCA Vm in the asymptomatic group was lower than that in the reference group, but the difference was not significant (P > 0.05). The PI (MCA pulsatility index) in the asymptomatic group was lower than that in the reference group (P < 0.05). Compared with the asymptomatic group, the symptom group had lower MCA Vm, which had a certain correlation with the Uchi Mie cycle. The CTP parameters of the three groups were compared. The results showed that there was no significant change in CBF (cerebral blood flow) in the asymptomatic group (P > 0.05), while the CBF in the symptomatic group decreased significantly (P < 0.05). In the mean transit time and peak arrival time, the asymptomatic group was longer than the symptom group (P < 0.05). There was no significant difference between the two groups of CBV (cerebral blood volume) compared with the reference group P > 0.05). Have a high consistency results conclusion the detection of TCD and CTP, two kinds of detection methods used in combination, can be better for unilateral carotid artery stenosis and occlusion of cerebral perfusion in patients with comprehensive and comprehensive evaluation, and then provide the basis for the best treatment options.