Abstract: Objective: To study the clinical applicative value of brain CT perfusion joint head and neck CT angiography with 64-slice multi-detectors CT for acute ischemic brain stroke. Methods: 50 cases of maybe acute cerebral infarction patients were collected to CTA and CTP examination within 12 hours after onset, and related clinical treatment in time. Head CT or MRI review were took 30 days later. Results: CBF, CBV of Infarct and contralateral corresponding area was significantly statistically different(P < 0.01), CBF, TTP of penumbra and contralateral corresponding area was significantly statistically different(P < 0.01), but CBV with no statistically significantly difference(P > 0.05). CTP diagnosis penumbra, compared with the results of the review, the difference was not statistically significant(P > 0.05), with a sensitivity of 95% and a specificity of 69%. Most plaque were found in the carotid bifurcation(21%), intracranial internal carotid artery(17%) and middle cerebral artery(19%), 52% of vulnerable plaque. Compared the stenosis between ipsilateral and contralateral feeding artery in patients with anterior circulation CTP abnormalities, the difference was statistically significant(P=0.005), the difference of plaque type and vulnerable plaque was statistically significant(P < 0.001). Conclusions: CTP can visually distinguish infarct and penumbra. Higher accuracy was found with method "CBV-TTP does not match, and delay TTP > 6 s" to diagnose penumbra, Moderate or more stenosis, soft plaques, mixed plaques and vulnerable plaques in feeding artery were positively correlated with stroke. CTP and CTA have a high application value for acute ischemic brain stroke.