Objective To investigate the value of ophthalmic artery transcranial Doppler (TCD) in predicting the change in intracranial pressure (ICP) in patients with intracranial venous sinus thrombosis (CVST).Methods The patients who were diagnosed with CVST and had visual impairment and binocular optic disc edema were enrolled. Ophthalmic artery TCD was performed before treatment and at 5-15 and 30-45 days after treatment, and lumbar puncture was performed immediately after ophthalmic artery TCD to record ICP. The pulsatility index (PI) of the intracranial and extracranial sections of the ophthalmic artery was used to calculate the rate of change of PI (ΔPI), and the correlation between ICP and ΔPI within the same period of time was analyzed.Results There was a strong correlation between ICP and ΔPI before treatment and at 5-15 and 30-45 days after treatment (P=0.000).Conclusions ΔPI of intracranial and extracranial sections of the ophthalmic artery can be used as a noninvasive index for predicting the change in ICP in patients with CVST.