Atherosclerosis accompanied by inflammation is considered to be a crucial mechanism for patients with ischemic stroke. We aimed to investigate the association between intracranial plaque characteristics and high-sensitivity C-reactive protein (hs-CRP) levels to predict the occurrence of acute cerebral infarction (ACI). 85 patients with cerebral infarction were divided into ACI group and non-acute cerebral infarction (NACI) group. Hs-CRP levels were further grouped into low, intermediate and high groups. We concluded that elevated hs-CRP levels was independently associated with strong plaque enhancement, their synergistic effects provided incremental value in predicting the occurrence of acute cerebral infarction.