Aim To observe the relationship between carotid artery stenosis and stroke in progression(SIP), and further discuss the risk factors of SIP. Methods 239 hospitalized patients from the Beijing Military General Hospital with acute cerebral infarction were randomly allocated into two groups: stroke in progression(SIP) group(n141) and stable cerebral infarction group(n98). Carotid ultrasonography examination was performed. The plasma Hcy were determined by radio-immunofluo rescence. The carotid artery stenosis degree and the plasma homocysteine levels of two groups were compared. Results The incidence of carotid artery stenosis in progress group was obviously higher than stable cerebral infarction group. The carotid artery stenosis is associated with stroke in progression. Logistic regression analysis show that hyperlipemia, homocysteine, carotid artery stenosis were the independent risk factors to stroke in progression(OR0.264，95%CI:0.064～1.260OR0.163,95%CI:0.036～0.743OR0.006,95%CI:0.036～0.568). Conclusion Carotid artery stenosis may be closely related to ischemic stroke in progression, and the level of Hcy is a prediction of progressive cerebral infarction.