The presence of intraplaque haemorrhage (IPH) has been related to plaque rupture, plaque progression, and predicts cerebrovascular events. However, the mechanisms leading to IPH are not fully understood. The dominant view is that IPH is caused by leakage of erythrocytes from immature microvessels. 101 patients underwent MRI of the symptomatic carotid plaque for detection of IPH and dynamic contrast-enhanced MRI for assessment of plaque microvasculature. A decreased vessel wall Ktrans was found for IPH positive patients. No difference in adventitial Ktrans was found in patients with and without IPH. Not only leaky plaque microvessels, but additional factors may contribute to IPH development.