AimTo explore the correlation between the clinical ischemic events and the character of carotid atherosclerotic plaque detected by computed tomography angiography (CTA). Methods100 patients with carotid atherosclerosis were divided into ischemic event group (n＝48) and non-ischemic event group (n＝52).The character of carotid atherosclerotic plaque was detected by 64 slices computed tomography (CT).Results103 plaques were detected in ischemic event group, of which, the incidences of fatty plaque, calcified plaque and mixed plaque were 35.4%, 30.1% and 34.5% respectively.78 plaques were detected in non-ischemic event group, of which, the incidences of fatty plaque, calcified plaque and mixed plaque were 21.8%, 51.3% and 26.9% respectively (p＜0.05).The proportion of mixed plaques, composed mainly by fatty plaque, was 64.1% and 23.8% respectively in ischemic event group and non-ischemic event group (p＜0.01).The incidences of ulcerated plaques was significantly higher in ischemic event group (n＝8) than that in non-ischemic event group (n＝2)(p＜0.05).ConclusionsCharacteristics of carotid atherosclerotic plaque can be accurately assessed by 64 slices CT.Patients with fatty plaques and mixed plaques composed mainly by fatty plaque are more likely to be symptomatic, compared to those with either calcified plaque.