Aim To evaluate the relationship between basic fibroblast growth factor (bFGF), carotid artery atheroscleorsis and cerebral ischemicin patients of essential hypertension. Methods B-mode ultrasound examination of common carotid artery (CCA) and internal carotid artery (ICA), bifurcation of carotid artery (BIF) was used. bFGF was measured by enzyme linked immunosorbent assay (ELISA) methods. Results The levels of bFGF (364.5±91.0 mg/L vs 283.4±91.2 mg/L), the incidents of soft plaques (92.3% vs 52.4%) and the peak of blood flow in stage with systole of right internal carotid artery (57.65±7.34 mm/s vs 52.41±7.97 mm/s) increased in patients of essential hypertension with cerebral ischemic group than those in patients of essential hypertension without cerebral ischemic group (P<0.05 or 0.01). The levels of bFGF in soft plaques group increased than that in flat plaques group (P<0.05). Conclusion Levels of bFGF and forming atherosclerosis may be an important factor during the development and discovery of cerebral ischemia, providing important basis for distingusihing the degree of desease with essential hypertension and preventing cerbral infarction, which contributes to intervene treatment.