Objective? To explore the diagnostic value of transcranial Doppler ultrasonography and the detedtion of triglyceride (TG),total cholesterol (TC) and low density lipoprotein (LDL) levels in ischemic cerebrovascular disease. Methods A total of 72 patients with ischemic cerebrovascular disease admitted to Wujin Hospital Affiliated to Jiangsu University from January 2019 to October 2020 were selected as the observation group, and 50 healthy subjects who underwent physical examination in the hospital during the same period were selected as the control group, carried out a prospective research. All subjects used the detection result of digital subtraction angiography(DSA) as the gold standard. All subjects underwent transcranial Doppler ultrasonography, and TG, TC, and LDL levels detection. Compared the blood lipid indexes and the results of transcranial Doppler ultrasound of subjects in the two groups; used DSA test as the gold standard, compared the diagnostic coincidence rate of transcranial Doppler ultrasonography combined with TG, TC and LDL levels detection in the diagnosis of ischemic cerebrovascular disease, and the accuracy rate of transcranial Doppler ultrasonography in the diagnosis of different degrees of cerebrovascular stenosis. Results? There was no statistically significant difference in serum TG and TC levels of subjects between the two groups (all P >0.05); The serum LDL level in the observation group was significantly higher than that in the control group; the pulsatility index of vertebral artery and basilar artery of patients in the observation group were significantly higher than those in the control group, and the average blood flow velocity of the vertebral artery and basilar artery were significantly lower than those in the control group;the diagnostic coincidence rate of transcranial Doppler ultrasonography combined with TG, TC, LDL levels detection in the diagnosis of ischemic cerebrovascular disease was significantly higher than that of TG, TC, LDL levels detection (all P <0.05); The diagnostic coincidence rate of mild stenosis, moderate stenosis, severe stenosis and complete occlusion detected by transcranial Doppler ultrasound were 83.87%,88.89%, 84.38% and 90.00%, respectively, and the total diagnostic coincidence rate was 86.31%. Conclusion In patients with ischemic cerebrovascular disease, the serum LDL level, vertebral artery and basilar artery pulsatility index increased abnormally, and the average blood flow velocity of vertebral artery and basilar artery reduced significantly. Transcranial Doppler ultrasound detection combined with TG, TC,LDL levels detection can help to improve the accuracy of its diagnosis.