Introduction: Cerebrovascular accident or stroke is one of the commonest neurological disorder affecting mainly the elderly population worldwide. Atherosclerosis is a major cause of stroke both ischemic and haemorrhagic.

Methods: This observational study was done with the aim of finding the type of atheromatous plaque and their incidence, unilateral or bilateral in ischemic stroke patients. After Ethical clearance 50 elderly patients (age group 50–70) admitted in a government hospital in Kolkata, West Bengal were taken. Results: After proper clinical examination, blood lipid profile, ultrasonographic evaluation of Carotid Intima Media Thickness it was found that pure single sided plaques (80.56%) were more common in cerebral ischemia and soft plaques(66.67%)  were more common than calcified plaques. Conclusion: Single sided plaques soft plaques in cerebral ischemia were more common than calcified plaques.: