The ability to rapidly and accurately evaluate the location and extent of hyperacute brain ischemia is of major clinical importance. Herein, we aimed to develop imaging criteria to classify the ischemic lesion by computed tomography (CT) perfusion (CTP) and CT angiography (CTA) in hyperacute ischemic stroke patient. Non-contrast-enhanced CT, CTP and CTA were performed in patients with symptoms of hyperacute stroke lasting,8 hours. According to the volume of infarct core, ischemic penumbra and vessel status, three ischemic lesion types were defined. Twenty-six patients were included in our study. Among them, ten patients were classified into severe group, 15 patients were classified into mild group and one patient was classified into reversible group. In acute stroke patients, the ischemic lesion typing may assist in individualizing therapeutic decisions for patients by possibly extending the window for giving thrombolytics beyond the current 3 hour limit.