Cystatin C, as a cysteine protease inhibitor, is an indicator of renal damage. At present, many studies suggest that the cystatin C may be a risk factor for atherosclerosis formation, and play an important role in vascular damage of ischemic stroke. There is a certain correlation between cystatin C and carotid atherosclerosis occurrence, development and disease prognosis in patients with ischemic stroke. This article reviews the research on the correlation between cystatin C and carotid atherosclerosis in patients with ischemic stroke in recent years.