Ischemic cerebrovascular disease is the leading cause of stroke. About 85% of strokes are ischemic in nature, with atherosclerosis as the basis, and the biggest problem facing stroke survivors is the occurrence of re-strokes and other ischemic events. Evidence from large randomized clinical studies also suggests that re-stroke is very likely. Stroke is also the leading contributor to death, with a 10-year mortality rate of 79%, of which the leading causes are initial stroke episodes 27% and cardiovascular lesions 26%. Ischemic cerebrovascular disease is also considered the most preventable disease, and it is estimated that 80% of stroke episodes can be prevented using modern means, including antihypertensive, lipid-lowering, antithrombotic, and surgical and endovascular treatments. The main clinical manifestations of ischemic cerebrovascular disease are TIA and cerebral infarction. Anterior circulation lesions such as unilateral blindness or black haze, Horner syndrome, unilateral or lateral limb weakness, numbness, speech impairment, and partial blindness are symptoms of carotid artery system ischemia, among which unilateral blindness or black haze and Horner syndrome mostly suggest that the lesion is located in front of the ophthalmic artery. Posterior circulation lesions are recurrent vertigo, transient bilateral black haze, episodic bilateral or unilateral limb numbness and weakness, perioral numbness, ataxia, nystagmus, syncope, tilting episodes, diplopia, and other symptoms. Atherosclerotic stenosis of the carotid artery is one of the major causes of stroke (10%-20% of stroke occurrences). Risk factors for the development of atherosclerosis include: 1. Non-modifiable risk factors: including age, gender and race. 2. Modifiable risk factors: hypertension, hyperlipidemia, diabetes mellitus, smoking, inflammation and chronic infection. The treatment of this disease has been a hot topic of global attention for many years. The traditional treatment is conservative medical therapy, but several randomized controlled studies more than a decade ago showed that carotid endarterectomy was superior to conservative treatment in preventing the occurrence of stroke, establishing CEA as the standard treatment option for carotid atherosclerosis. Although CEA is effective in preventing stroke due to carotid artery stenosis, it is a major procedure that requires general anesthesia and is limited by many factors, such as patient age, cardiac, hepatic, and renal function, and high-risk patients such as these have been excluded from all CEA studies. Intracranial artery stenosis is another major cause of stroke reoccurrence. The cause of intracranial artery stenosis is not very well understood, and the main surgical treatment for patients with intracranial artery stenosis is extracranial bypass surgery (EC/IC). Endovascular treatment techniques developed in recent years have opened up new treatment methods for intracranial artery stenosis, namely intracranial vascular stent implantation angioplasty, which can be performed by experienced physicians to effectively prevent recurrent strokes. Therefore, once the above symptoms occur, TCD, carotid ultrasound, CT, MRI should be performed in a timely manner at a hospital in a position to do so, and if stenosis is found, further whole brain angiography should be performed to confirm the diagnosis. The treatment time should not be delayed by passive infusion of conservative treatment. In conclusion, the prevention and treatment of ischemic cerebrovascular disease is currently a hot topic in neuroscience, and is in the process of exploration in many aspects. A lot of work needs to be done to standardize the methods of this major disease that endangers human health, reduce the mortality and disability rate, and improve the quality of life of people.