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Hyperhomocysteinemia (HHcy) is considered to be an independent risk factor for atherosclerosis. We aimed to determine the relation between Hcy and cerebral artery stenosis in a large Chinese population. We present data concerning 2,500 residents. Plasma was saved from 1,020 residents who were asymptomatic. Hcy concentration was measured by fluorescence ration biochemical assay kit, and middle cerebral artery (MCA) was assessed by Transcranial Doppler in these subjects. Fifty-six residents with MCA stenosis were included in this study. The remained 964 residents without stenosis were control. Analysis of the data revealed that the plasma concentration of Hcy (18.33 ± 5.34 µmol/L), age (63.9 ± 12.9) and systolic pressure (142.6 ± 22.6 mmHg) in the stenotic group were increased (p < 0.0001) compared with the control group (Hcy12.95 ± 4.57 µmol/L, age 55.8 ± 10.9, systolic pressure 126.3 ± 20.3 mmHg). Based on logistic regression, 5 factors emerged as independent predictors of MCA stenosis: Hcy (OR = 1.16, 95%confidence interval 1.14–1.26), male (OR = 2.63, 95%CI 1.49–4.66), age (OR = 1.04, 95%CI 1.01–1.07), hypertension (OR = 9.16, 95%CI 4.57–18.35), diabetes mellitus (OR = 5.90, 95%CI 3.09–11.29). Hyperhomocysteinemia might be one of the risk factors for cerebral artery stenosis. It may play a role in atherosclerosis and thrombosis. [ABSTRACT FROM AUTHOR]