Aim By comparing characteristics in patients with recurrent cerebral infarction and first cerebral infarction with computed tomography angiography （CTA）， to explore possible factors in patients with recurrent cerebral infarction. Methods We retrospectively analysed the test results of 140 cases of recurrent cerebral infarction patients and 235 cases of patients with head and neck CTA, and compared the characteristics of the two groups of patients with head and neck vascular lesions. Results Head and neck artery stenosis rate in patients with recurrent cerebral infarction was higher than that in patients with first cerebral infarction （90.0% vs. 64.7% P＜0.01）. Head and neck artery moderate stenosis and severe stenosis proportions in patients with recurrent cerebral infarction were higher than those in patients with first cerebral infarction （34.9% and 45.2% vs. 19.7% and 15.8% P＜0.01）. The incidence of head and neck artery plaque in patients with recurrent cerebral infarction was higher than that in patients with first cerebral infarction （91.4% vs. 66.4%, P＜0.01）. The proportion of soft plaque and ulcer plaque in patients with recurrent cerebral infarction were significantly higher than those in patients with first cerebral infarction （36.3% and 48.0% vs. 22.7% and 37.3% P＜0.05）. Conclusions Recurrent cerebral infarction is related to head and neck artery stenosis, the degree of stenosis and unstable plaque, the degree of stenosis and plaque may be one cause of recurrent cerebral infarction.