Objective To compare the application value of dual-source high resolution spiral CT and color ultrasound in the diagnosis of carotid artery lesions in patients with cerebral infarction. Methods A total of 102 patients with cerebral infarction admitted to our hospital from January 2018 to December 2019 were selected for comparative analysis with dual-source high-resolution spiral CT and color ultrasound on the degree of carotid artery stenosis, detection of vascular plaques in different parts of the carotid artery and types of carotid artery plaques. Results The analysis of the degree of carotid artery stenosis in patients with cerebral infarction by dual-source high resolution spiral CT and color ultrasound was basically the same without significant difference. However, the number of plaques in internal carotid artery and external carotid artery vessels detected by dual-source high-resolution spiral CT in patients with cerebral infarction was significantly higher than that in the color ultrasound group, showing a statistical difference (χ ²=16.06, P=0.0001; χ ²=18.73, P=0). At the same time, the number of soft spots and ulcerative spots detected by dual-source high resolution spiral CT was significantly higher than that of the color doppler ultrasound group (χ ²=9.16, P=0.0025; χ ²=9.48, P=0.0021). Conclusion Dual source high resolution spiral CT and color doppler ultrasound have good sensitivity to the degree of carotid artery stenosis. But dual source high resolution spiral CT can carry out in-depth analysis on the vascular plaques and types of plaques in different parts of the neck, which has a high application value in the diagnosis of cerebral infarction.