Background and Purpose: Ischemic stroke is a major cause of death and chronic disability, thus proper diagnosis and management is important. Ischemic strokes involving the anterior circulation due to intracranial stenotic lesions are believed to be much more common in Asians and Africans rather than in other populations. This abnormality can be noninvasively assessed with transcranial Doppler sonography (TCD) and computed tomographic angiography (CTA). To our knowledge, the usefulness of TCD sonography compared with CTA in the diagnosis of intracranial stenotic disease involving the anterior circulation has not been thoroughly studied.Methods: We prospectively examined 29 patients with clinically suspected anterior circulation stroke by using TCD sonography and CTA, together with 22, age and sex matched volunteers who were also examined by TCD sonography as a control group.Results: As regards CTA evaluation of the patients among the study group, we found that sensitivity of CT angiography in detection of intracranial stenosis of MCA and ACA was 62%. The sensitivity and specificity of variable TCD parameters in the study group were as follows: As regards peak systolic; the sensitivity was 76% and specificity 73%. End-diastolic and mean velocity values had a sensitivity of 83% and specificity of 73%. Resistivity index had a sensitivity of 90% and specificity of 68%.The sensitivity of TCD values all together were 72.4% and specificity was 95.5%.Statistically significant differences were noted in TCD parameters between normal controls and study group ipsilateral to infarction side. Significant differences were also found between MCA and ACA values on comparing contra lateral to ipsilateral side of the infarction. There was no significant difference on comparing values of all TCD parameters, to CTA results. Frequency distribution of patients having normal and abnormal TCD values of MCA ipsilateral to infarction in different clinical features was illustrated. As regards the clinical data observed in patients of the study group, no relation was found on comparing results of TCD to various clinical features observed in the study group.Conclusion: In this population, abnormal TCD results are highly suggestive of intracranial stenosis. TCD was able to detect abnormalities in both MCA and ACA in patients suffering from cerebral infarction. CTA was proven to be complementary and not directly comparable to TCD sonography in detection of intracranial stenosis