Background: Stroke is one of the most important causes of mortality and morbidity in the world and about 15% of strokes are due to large vessels involvements such as extracranial carotid artery disease. It is possible to decline the risk of stroke due to carotid artery stenosis by surgical or non-surgical investigations. Aim: To assess the extracranial carotid artery in patients with ischemic stroke by color Doppler ultrasonography (CDS). Materials: This cross-sectional study was done to determine the prevalence of carotid artery stenosis in the ischemic stroke patients. The data were gathered by completing data gathering sheets and review of the patients charts. The demographic data and those obtained from carotid CDS were gathered and then analyzed using Chi-square, and Logistic Regression test. Results: Among 200 evaluated ischemic stroke patients, 93(47%) were male and 107(53%) were female. The prevalence of severe stenosis (>70%), moderate stenosis (50%to70%) and mild stenosis (<50%) was 2.5%, 23.9% and26%, respectively. The prevalence of stenosis was 23%, 21% and 27.4% in the age groups of <50 years, 50-70 years, and >70 years, respectively. There was no significant relationship between stenosis and diabetes, ischemic heart disease, hyperlipidemia, or hypertension; however, there was a significant relationship between age and stenosis (P=0.02) Conclusion: The prevalence of extracranial carotid stenosis in Iran is higher than that of most Asian studies but it is close to western countries' reports.