The aim of this study was to investigate the relationship between the different kinds of leukoaraiosis (LA) and carotid atherosclerosis (AS) plaques. A total of 208 LA patients were divided into three groups, namely, circumventricular (Group I, n=68), subcortex (Group II, n=66), and mixed types (Group III, n=74). The AS plaques and stenosis of the carotid were detected using color Doppler flow imaging and the magnetic resonance images of patients, respectively. Among the patients enrolled in this study, 67.79% (141/208) had AS plaques, 24.04% of which was detected in Group II (50/66), 25.96% from Group III (54/74), and 17.79% from Group I (37/68), with significant difference among all groups. By contrast, the score of the stable plaques was identical, with all the AS plaques scoring under three grades. The Grades I/II/III plaques of the subjects in Group I were 45/40/47, respectively; Group II had 20/40/47; and Group III had 20/31/34. The Grades I/II/III plaques among the 52 subjects with cortid stenosis (50%) were 15/19/18 without any differences. The carotid AS plaque is one of the risk factors of LA and the fragments of vulnerable plaques related to leukoaraiosis.