Hyperperfusion syndrome was a severe complications of carotid endarterectomy (CEA), the routine measurement for preventing this was to take antihypertensive drugs for at least one week after operative. But there were no definite criteria to assess whether this method was reasonable and appropriate; our objective was to detect dynamic CBF changes in 4-day follow up after CEA using 3D pCASL technique. It is seen that compared to patients before CEA, both the ipsilateral and opposite CBF values were increased in various time points after CEA (P<0.05), whereas, the bilateral CBF values shows no significant differences (P>0.05). This shown that 3D pCASL is sensitive to temporal hemodynamic changes after CEA and may provide a quantitative criterion for assessing antihypertensive drugs taken. Also the observed increases shortly in the first and the second day after operations may suggest for potential drug intervention in case of post-CEA complications.