Abstract: Stroke is the leading cause of disability and mortality among patients with cardiovascular (CV) and cerebrovascular (CBV) diseases in China, with ischemic stroke accounting for approximately 80% of all cases. The core pathological mechanism involves CBV occlusion, whereas capillary obstruction and microcirculatory dysfunction are critical factors that influence disease progression, prognosis, and therapeutic response. Early diagnosis and screening of capillary pathologies during the asymptomatic phase is a fundamental requirement for reducing disease burden. Conventional clinical imaging techniques, such as computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA), are effective in diagnosing macrovascular lesions. However, due to limitations in spatial resolution, they are unable to directly visualize cerebral capillaries, which have diameters of 5-10μm. Instead, these techniques indirectly reflect microcirculatory impairments through methods such as CT perfusion to assess the ischemic penumbra or MR diffusion/perfusion imaging to indicate the no-reflow phenomenon. Emerging high-resolution technologies, including optical coherence tomography angiography (OCTA), micro-CT, and two-photon microscopy, enable direct capillary imaging and have demonstrated considerable potential for basic research and retinal microvascular monitoring. However, constraints such as limited penetration depth, invasiveness, and radiation exposure have hindered their clinical translation. This article systematically compared the capabilities of various imaging techniques in detecting cerebral capillaries, aiming to assist clinicians in selecting appropriate microcirculation assessment tools and support researchers in overcoming technological barriers, thereby ultimately advancing the optimization of early diagnostic and screening strategies for ischemic stroke.