Backgrounds: Carotid artery stenosis could be a harmful source of cerebro vascular accident (CVA). The ratio of internal carotid artery peak systolic velocity devided by common carotid artery peak systolic velocity (ICA/CCA) was useful predictive parameter of carotid stenosis. The aim of this study was to investigate biochemical predictors of the ratio of ICA/CCA in patients with CVA. Methods: A total of 169 consecutive patients (63.97짹12 years, 91males) with CVA which confirmed by neurologic examination and imaging modality were enrolled. Clinical and various biochemical markers were analyzed. Results: The levels of hemoglobin (13.35짹2 g/dl, r=-0.176, p<0.05), triglyceride (120.27짹70 mg/dl, r=-0.211, p<0.05), low density lipoprotein (116.29짹34 mg/dl, r=-0.218, p<0.05) and N-terminal pro B-type natriuretic peptide (NT-pro BNP) (728짹237 pg/dl, r=-0.322, p<0.05) were significantly associated with carotid blood flow by uni-variate analysis. Triglyceride (棺=-0.002, p=0.013) was an independent factor of carotid blood flow in this patients group. Conclusions: The result of this study suggested that the level of triglyceride was an independent predictor of carotid blood flow in patients with CVA. Triglyceride will be a useful biochemical marker for risk stratification of carotid blood flow in patients with CVA.