Stroke, a kind of cerebrovascular event, affects a large percentage of the population and is a leading cause of death and disability. Ischemic and hemorrhagic strokes are two different types of strokes. In the lungs and kidneys, active endothelial cells produce and release endocan, a dermatan sulphate proteoglycan that is soluble in water. Pro-inflammatory cytokines regulate its production. TNF-, IL-1, LPS, and angiogenic agents such as vascular endothelial growth factor (VEGF) increase endocan synthesis and secretion, whereas interferon- decreases endocan synthesis and secretion. To predict stroke and coronary heart disease (CHD), a noninvasive intermediate measure is the carotid intima–media thickness (IMT). IMT is also an indicator of cardiovascular risk factors and atherosclerosis in the carotidartery Risk factors for stroke and brain haemorrhage include common carotid artery plaque and an IMT of >0.9mm in the whole carotid artery. CCA plaque was linked to an increased risk of cerebrovascular illness.. The purpose of this research is to see whether carotid Doppler may help in the diagnosis of acute ischemic stroke. It is important for us to better understand the role of intima-media thickness (IMT) as an early and reliable measure of atherosclerosis in the study of ischemic cerebrovascular stroke (CVS) and subclinical atherosclerosis (CCA). Detection of patients at high risk of developing cerebrovascular symptoms will be improved by the use of IMT assessment in primary prevention. To find out whether stroke severity and intima-media thickness are linked. Cerebrovascular stroke patients' serum endocan levels should be measured as an atherosclerosis marker. Patients at high risk of cerebrovascular stroke may be identified early on by measuring their serum endocan levels. In this section, you will learn about the research methods and findings. Cerebral vascular stroke patients and control volunteers of the same age and gender were included in the research. All of the participants had their common carotid artery intima-media thickness and serum endocan tested. The NIHSS was administered to all participants as part of a comprehensive history-taking, as well as a general and detailed neurological assessment. This study found that higher intima media thickness (IMT) of the common carotid artery (CCA) is related with increased risk of stroke and increased stroke severity (p 0.0001). IMT of CCA increases with age (P 0.0001). The increased risk of cerebrovascular stroke occurrence and increased stroke severity is associated with increased IMT of the common carotid artery, which is a sign of atherosclerosis, as well as increased serum endocan, which is a sign of atherosclerosis and endothelial dysfunction. Combined with early preventive measures, non-invasive CIMT and endocan measurements could significantly reduce the risk of stroke