Introduction:　This　study　aimed　to　examine　whether　intraplaque　neovascularization　(IPN)　of　carotid　plaques,　as　characterized　by　contrast-enhanced　ultrasound　(CEUS),　is　associated　with　ischemic　stroke　recurrence　in　patients　with　carotid　atherosclerosis.　Methods:　We　conducted　a　prospective　study　of　consecutive　patients　with　a　recent　stroke　and　at　least　one　atherosclerotic　plaque　in　the　carotid　artery　on　the　side　consistent　with　symptoms.　All　patients　underwent　CEUS　after　their　first　admission.　IPN　was　graded　on　the　basis　of　the　presence　and　location　of　microbubbles　within　each　plaque.　Results:　We　eventually　included　155　patients,　all　of　whom　underwent　IPN　analysis.　After　a　follow-up　of　24　months,　we　recorded　25　(16.1%)　stroke　recurrences　in　the　whole　population.　All　the　recurrences　occurred　in　patients　presenting　IPN.　There　was　significant　difference　in　the　IPN　between　the　2　groups　(p　=　0.002).　In　the　final　Cox　proportional-hazards　multivariable　models,　IPN　of　grade　2　was　independently　associated　with　the　risk　of　stroke　recurrence　(HR　=　4.535;　95%　CI:　1.892-10.870;　p　=　0.001).　This　association　remained　after　adjusting　for　the　degree　of　carotid　stenosis　(HR　=　3.491;　95%　CI:　1.410-8.646;　p　=　0.007).　Conclusions:　IPN　was　an　independent　predictor　of　stroke　recurrence　in　patients　with　a　recent　ischemic　stroke　and　carotid　atherosclerosis.　In　predicting　stroke　recurrence,　IPN　may　be　an　earlier　indicator　than　carotid　stenosis　and　may　help　stratify　the　risk　of　stroke　recurrence.