Abstract: Objective To analyze the relationship between dietary inflammatory index (DII) and carotid atherosclerosis (CAS) plaques. Methods Patients who were admitted in Department of Neurology, Pizhou Hospital Affiliated to Xuzhou Medical University were enrolled and their clinical data were collected. According to the presence of atherosclerotic plaque by carotid ultrasound, they were divided into two groups(n=100): an atherosclerotic plaque group and a non-atherosclerotic plaque group. Their dietary and general information were collected, and DII and neutrophil to lymphocyte ratio (NLR) were calculated. Logistic regression was used to analyze the risk factors of carotid atherosclerotic plaque and the relationship between DII and the degree of stenosis of carotid atherosclerotic plaque. Results The atherosclerotic plaque group showed a higher value of DII than that of the control group (P<0.001). The DII value was positively related with the risk of CAS plaque formation (OR=3.376, 95%CI: 2.515—5.551). DII value was related with the stenosis of carotid atherosclerotic plaque (P<0.001). There was no significant correlation between DII value and WBC count, neutrophil percentage, lymphocyte percentage and NLR (P>0.05). Conclusions DII value has certain correlation with the formation of CAS plaque and its stenosis degree, without significant correlation with WBC count and NLR.