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Introduction: The intracranial Atherosclerosis disease represents a frequent cause of ischemic stroke in which the study with transcranial Doppler constitutes an important tool for the diagnosis. Case report: Male of 39 years old referred to consultation with a history of stroke of uncertain cause. The rmagnetic resonance image demonstrated a left striatum-capsular infarction. The transcranial Doppler showed a focal increase of the flow rates compatible with a stenosis in the proximal segment of left middle cerebral artery that was demonstrated later in the computed tomography angiography. This case don't have another embolic source (arterial or cardiac) and have some vascular risk factors (hypertension, and increase of serum triglycerides). Five month later the changes in the flow blood velocity persisted in transcranial Doppler ultrasound. Conclusions: In this case, the transcranial Doppler and Transcranial Color Doppler Sonography allowed a reliable diagnosis of intracraneal stenosis. The persistence of hemodynamic changes and the exclusion of other causes of intracranial stenosis suggest the atherosclerotic cause. [ABSTRACT FROM AUTHOR]