〔Abstract〕 Objective To analyze the value of cervical vascular ultrasound (CVUS) combined with computed tomography angiography (CTA) in predicting adverse cardiovascular events after acute stroke. Methods A total of 70 patients with acute stroke who completed emergency thrombolysis intervention in Nanyang First People's Hospital from January 2020 to January 2022 were selected as the study subjects. All patients were followed up until January 1, 2023. Patients with adverse cardiovascular events were included in an observation group, while those without adverse cardiovascular events were included in a control group. The CVUS and CTA indexes of the two groups were retrospectively analyzed and compared, and the predictive value of CVUS combined with CTA in postoperative adverse cardiovascular events was evaluated. Results There was no significant difference in internal carotid artery resistance index (RI) between the two groups (P > 0.05). The pulse index (PI) of the observation group was higher than that of the control group, and the peak systolic flow velocity (Vs) and end-diastolic flow velocity (Vd) were lower than those of the control group, the differences were statistically significant (P < 0.05). The internal carotid artery blood flow (BF) and blood volume (BV) in the observation group were lower than those in the control group, and the mean transit time (MTT) was higher than that in the control group, the differences were statistically significant (P < 0.05). Receiver operating characteristic curve (ROC) analysis showed that the maximum area under the curve of CVUS combined with CTA for predicting adverse cardiovascular events after acute stroke was 0.705. Conclusion The incidence of adverse cardiovascular events after acute stroke is relatively high, which may be accompanied by abnormal CVUS combined with CTA parameters. CVUS combined with CTA has a high predictive value for the occurrence of adverse cardiovascular events after acute stroke.