Objective To investigate the clinical efficacy of transcranial Doppler ultrasonography on emergency thrombolytic therapy in stroke. Methods A total of 70 stroke patients who received emergency thrombolytic therapy in stroke at a hospital in Zhengzhou from June 2019 to June 2021 were selected as the study subjects. All patients underwent CT angiography（CTA） as well as transcranial Doppler（TCD） examination

and the results were examined and compared with ″golden standard″ digital subtraction angiography（DSA）. The sensitivity

specificity and accuracy of CTA and TCD were compared. To compare the efficacy of TCD and CTA in the diagnosis of stroke: the receiver operating characteristic curve（ROC） was established

and the area under the curve（AUC） of TCD and CTA diagnosis was calculated. Results The diagnostic accuracy

sensitivity and specificity of TCD were 97.14%

94.44% and 97.14%

respectively

which were higher than those of CTA（85.71%

75.00% and 85.71%

respectively）. The differences were statistically significant（P<0.05）. There was no significant difference in the diagnostic accuracy

sensitivity

and specificity of TCD and DSA（P >0.05）. The ROC showed that the diagnostic efficacy of TCD（95%CI: 0.865～0.921; AUC: 0.865） was higher than that of CTA（95%CI: 0.855～0.928; AUC: 0.835）. Conclusion Compared with CTA and TCD

CTA and TCD are of great importance in guiding clinical treatment and improving the prognosis of patients with stroke. These advantages justify a wider application of this procedure in clinical practice.