Aim To explore the characteristics of head and neck artery CT vascular imaging of 256-slice CT angiography in patients with progress ischemic stroke. Methods We retrospectively analysed the test results of 106 cases of progressive ischemic stroke and 269 cases of non progressive ischemic stroke of head and neck CT vascular imaging of 256-slice CT angiography, compared the characteristics of the two groups of patients with head and neck vascular lesions.Results （1） Head and neck artery stenosis rate was 91.5% in patients with progress ischemic stroke, which was higher than in patients with non progressive ischemic stroke （58.7%, P< 0.05）. And in the arteries of patients with progress ischemic stroke，the proportion of moderate stenosis and severe stenosis （37.1% and 46.4%） was higher than non progressive ischemic stroke patients （7.0% and 3.1% P<0.05）.（2） In patients with progress ischemic stroke, head and neck artery plaque incidence （94.3%） was higher than that in non progressive ischemic stroke patients （65.8%, P<0.05）. The proportion of soft plaque and ulcer plaque （37.0% and 48.0%） was significantly higher than non progressive ischemic stroke patients （22.6% and 31.6% all P<0.05）. （3） The proportion of moderate stenosis and severe stenosis （43.4% and 50.0%） in head and neckartery was higher in early progressive ischemic stroke patients than that of patients with advanced type （14.3% and 23.8%） （all P<0.05）, and the proportion of soft plaque and ulcer plaque in patients with early progressive type （40.0% and 45.7%） was higher than that of patients with advanced type （16.7% and 20.0%） （all P<0.05）.Conclusions Progress ischemic strokes is related to head and neck artery stenosis, the degree of stenosis and unstable plaque, and arterial stenosis and plaque characteristics can be used as predictors of disease progression.