Objective: To investigate the diagnostic value of carotid artery ultrasonography, CT angiography (CTA) and digital subtraction angiography (DSA) for carotid artery dissection. Methods The image data of carotid artery ultrasonography, CTA, and DSA of 24 patients with carotid artery dissection were analyzed retrospectively. Results: Twenty-four, 16, and 21 patients were examined with DSA, CTA, and carotid artery ultrasonography respectively. The detection rates of carotid artery dissection with DSA, CTA, and carotid artery ultrasonography were 95. 8%,75. 0%, and 71.4% respectively. The DSA mostly showed the line-like sign (n = 12, 50 %). CTA and carotid artery ultrasonography mostly showed the double lumen sign; they were 37.5% (n =6) and 52. 4% (n = 11) respectively. Compared with DSA, the concordance rates of carotid artery ultrasonography and CTA were 66.7% and 81.3% respectively. There was no significant difference (Kappa = 0.39, P = 0.08 and Kappa = 0.43, P = 0.22 respectively). The concordance rate of ultrasonography in combination with CTA and DSA reached 87.5% (re = 15, Kappa = 0.67, P = 0.047). There was significant difference. Conclusion: DSA is a gold standard for the diagnosis of carotid artery dissection, and it is irreplaceable. Carotid artery ultrasonography in combination with CTA can improve the diagnostic rate. Carotid artery ultrasonography can be used as a screening method for carotid artery dissection.