Aim To analyze the correlation of autophagy level and carotid plaque of ischemic cerebrovascular disease, so as to provide data evidence to its pathomechanism. Methods 127 patients with ischemic cerebrovascular disease were divided into 3 groups according to carotid plague scores. The count and degree of cranial artery stenosis were observed with digital subtraction angiography. The fasting venous blood of patients was extracted to separate mononuclear cells and detect autophagosome by Dan acyl glutaric amine dyeing. At the same time, total protein of the fasting venous blood was extracted to detect autophagy related factor levels LC-Ⅱ/LC-Ⅰ and Beclin-1. Results There was difference in intima-media thickness, vascular stenosis number and degrees between different patches prioritization, and the Grade Ⅱ and Ⅲ were both higher than Grade Ⅰ, Grade Ⅲ was higher than Grade Ⅱ (P＜0.05). There were autophagy and autophagic apoptotic cells in the ultrathin section of peripheral blood mononuclear cells, and autophagy with green fluorescence was also observed in the leica microsystems after Dan acyl glutaric amine. There was difference in LC-Ⅱ/LC-Ⅰ and Beclin-1 levels between different patches prioritization, and the Grade Ⅱ and Ⅲ were both higher than Grade Ⅰ, Grade Ⅲ was higher than Grade Ⅱ (P＜0.05). We found that LC-3Ⅱ/LC-3Ⅰ and Beclin-1 protein expression level was positively correlated with intima-media thickness (R²=0.75, 0.79). Conclusion Autophagy can affect the carotid artery plaque of ischemic cerebrovascular disease, which may be the one of the important mechanisms.