Background: The concept of `silent stroke' or `asymptomatic cerebrovascular lesion' has been established by many investigations, and prevalence, risk factors, clinical outcome and associated pathological changes (WMCs and underlying vasculopathy) have been studied. The aim of the work is to use Carotid Doppler as a screening tool for silent cerebral Stroke with MRI imaging in hypertensive patients. Methods: This study included 50 hypertensive patients, All patients underwent magnetic resonance imaging of the brain searching for Asymptomatic cerebral infarction. Patients with silent brain stroke underwent Duplex sonography of carotid artery. Results: Normal MRI findings occurred in only 8% of patients. Lacunar infarction, ischemic changes and microbleeds occurred in 78%, 72% and 24% of patients. High PSV occurred in 48% of the studied patients and 90% of them had normal EDV, Normal Carotid findings occurred in only 10% of patients. Atherosclerosis without plaques were detected in 30% of patients while 60% of patients had combined atherosclerosis with plaques, Abnormal carotid Doppler findings detect 43 out of 46 patients with findings suggestive of silent stroke with sensitivity 93.5% and normal carotid Doppler occurred in 2 out of 4 patients with normal MRI study with specificity 50%. Positive predictive value (PPV) was 95.6% while negative predictive value (NPV) was 40% and accuracy 90%. There is significant agreement between presence of abnormal findings on carotid Doppler and findings of silent stroke by MRI, Conclusion: Carotid atherosclerosis can be proposed as a marker for susceptibility to ischemic cerebral damage.