Abstract: objective: To retrospectively analyze the imaging findings of asymptomatic carotid artery stenosis patients to evaluate the occurrence and development of atherosclerotic disease and its clinical correlation. Methods: A retrospective analysis of 81 patients with asymptomatic carotid artery stenosis with head and neck CTA was conducted to evaluate the image quality and the properties of atherosclerotic plaques, and to calculate the stenosis degree. Pearson correlation test was performed for degree of carotid artery stenosis and coronary artery stenosis, degree of carotid artery stenosis and white matter lesions, degree of carotid artery stenosis and coronary artery ACC/AHA score. According to whether the degree of total internal carotid artery stenosis is >50% or not, it can be divided into two groups: asymptomatic carotid artery stenosis group and control group. Independent sample t test was conducted for the degree of coronary artery stenosis between the two groups. The results of head MRI were scored, and the t test between the two groups was performed. The incidence of atherosclerosis in aortic arch in asymptomatic carotid artery stenosis group and control group was evaluated by chi-sqaure test. Results: The degree of carotid artery stenosis was positively correlated with the degree of coronary artery stenosis, the degree of carotid artery stenosis with the degree of white matter lesion, and the degree of carotid artery stenosis with the degree of coronary artery ACC/AHA score compared with the control group, there were statistically significant differences in the t-test results of asymptomatic carotid artery stenosis in patients with coronary artery plaque formation (P<0.05). The corresponding head MRI findings in the asymptomatic carotid artery stenosis group showed lacunar cerebral infarction and white matter lesion were heavier than those in the control group, and there were significant statistical differences in t test results between the two groups (P<0.05).The incidence rate of atherosclerosis in the aortic arch was statistically significant by four-grid chi-square test (P<0.05). Conclusion: Atherosclerosis is a systemic disease. The degree of total internal carotid artery stenosis is associated with the development of coronary atherosclerosis and aortic atherosclerosis. The degree of coronary artery stenosis is related to the degree of stroke and the corresponding total internal carotid artery stenosis.