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Background: Coronary artery stenosis (CAS) is a common comorbidity in acute ischemic cerebrovascular disease (AICVD) patients, which may portend a worse outcome. However, few studies have comprehensively evaluated cervicocephalic atherosclerotic burden and its significance for predicting CAS in AICVD patients.Methods: AICVD patients admitted to a single stroke unit from January 1st, 2016 to June 30th, 2016 were consecutively enrolled and underwent combined coronary and cervicocephalic computed tomography angiography. CAS was defined as stenosis≥50% in at least one coronary artery. The burden of cervicocephalic atherosclerosis was evaluated based on the severity and extent of affected arteries. Univariate analysis and multivariate analysis were conducted to assess the difference between the group with AICVD and CAS and another group with AICVD only.Results: In 140 included AICVD patients, 44(31.4%) had concomitant CAS. Male (93.2% vs 77.1%,p=0.021), systolic blood pressure on admission (156.89 vs 148.57mmHg,p=0.044), known history of coronary artery disease (31.8% vs 7.3%,p<0.001), and serum creatinine level (64.53 vs 71.93mmol/L,p=0.027) were significantly different between the two groups. In multivariate analysis, the severity of atherosclerosis in the common carotid, intracranial vertebrobasilar or posterior cerebral arteries, the number of atherosclerotic extracranial, intracranial or total cervicocephalic artery segments, as well as the number of affected extracranial or total cervicocephalic artery segments with stenosis≥50%, were associated with the coexistence of AICVD and CAS, independently of conventional vascular risk factors.Conclusions: The risk for AICVD patients to have concomitant CAS may increase with the severity and extent of atherosclerosis in cervicocephalic arteries. A comprehensive assessment of atherosclerotic burden in the cervicocephalic arterial tree is important to predict CAS in AICVD patients.