【Abstract】 Objective To study effect of different doses of atorvastatin calcium in treatment of acute cerebral infarction and its effect on carotid atherosclerotic plaque and vascular endothelial function. Methods 96 patients of acute cerebral infarction received therapy from February 2015 to August 2017 in our hospital were selected as research objects. According to random number table, those patients were divided into the A group (n=48) and the control group (n=48). On the basis of routine symptomatic treatment, they were treated with atorvastatin, the dose of A group was 10mg/times/d, the dose of A group was 10mg/ times/d for 3 months. The clinical efficacy, blood lipid, carotid intima media thickness (IMT), plaque area, vascular endothelial function, National Institutes of Health Stroke Scale (NIHSS) score and adverse reactions were compared between the two groups. Results After treatment, the total effective rate of group B was 9375%, which was significantly higher than that of A group(P＜005). After treatment, the serum total cholesterol (TC), three acylglycerol (TG) and low density lipoprotein (LDLC) in the two groups were significantly lower than those before treatment, and the highdensity lipoprotein cholesterol (HDLC) increased significantly(P＜005). The TC, TG and LDLC in group B were significantly lower than that of A group, and HDLC was significantly higher than that of A group(P＜005). After treatment, the carotid artery IMT and plaque area in the two groups were significantly reduced (P＜005). The carotid artery IMT and plaque area in B group was less than that of A group (P＜005). After treatment, the nitric oxide (NO) and vasodilatation (FMD) in the two groups were significantly increased, and the endothelin (ET) 1 decreased significantly (P＜005). The NO and FMD in B group were higher than that of A group. The ET1 in B group was lower than that of A group(P＜005). After treatment, the NIHSS scores in the two groups were significantly reduced (P＜005), and the NIHSS score in group B was significantly lower than that in the A group (P＜005). There was no significant difference in the incidence of adverse reactions between the two groups(P＞005). Conclusion Atorvastatin with large dose (20mg/times/d) is effective for acute cerebral infarction, which can effectively improve blood lipids, carotid atherosclerotic plaques, vascular endothelial function and neurological function, and does not increase adverse drug reactions, so it has high clinical application value.