To investigate the association of chronic kidney disease (CKD) and intracranial artery stenosis (ICAS), as well as its effects on ICAS distribution in the middle-aged and elderly population. Data from the China Hypertension Survey in Beijing was analyzed. Estimated glomerular filtration rate (eGFR) was used to evaluate CKD, and ICAS was assessed by transcranial doppler. Clinical and biochemical variables were compared between the ICAS group and the non-ICAS group, as well as in different vascular distribution groups. Univariable and multivariable logistic regression analyses were introduced to demonstrate the association between CKD and ICAS. A total of 3678 subjects were included in this study, with a mean age of 62 years old. Of which, 19.2% presented with decreased eGFR (eGFR ＜60 ml/min/1.73 m2) and 17.4% for ICAS. The percentage of anterior circulation ICAS was 3.5 times than that of posterior circulation (10.9% vs. 3.1%). In multivariable regression analysis, eGFR ＜45 ml/min/1.73 m2 was independently associated with ICAS after correction for covariates, odds ratio (OR)=1.69, 95% confidence interval (CI) (1.08, 2.65); in particular, this association had a preference for posterior circulation but not anterior circulation ICAS with OR=2.29, 95% CI (1.28, 4.07) and OR=1.44, 95%CI (0.89, 2.33), respectively. Severe eGFR decline is associated with ICAS in the middle-aged and elderly population, and this correlation is more related to posterior circulation ICAS.