Objective To investigate cerebral artery stenosis (CAS) in patients with minor ischemic stroke (MIS) and its related factors. Methods A total of 402 patients with acute MIS (National Institutes of Health Stroke Scale[NIHSS] ≤ 5) who were hospitalized in the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, from January 2015 to July 2018 were selected as study subjects. NIHSS and Stroke Prognosis Instrument Ⅱ (SPI-Ⅱ) scores were evaluated for the patients in acute phase to investigate vascular risk factors, and the CAS condition was evaluated by head and neck computed tomography angiography. The patients were divided into intracranial and/or extracranial artery stenosis groups as well as mild, moderate, and severe stenosis or occlusion groups, according to the location and degree of arterial stenosis, and were divided into young (≤ 44 years), middle-aged (45-59 years), and elderly (>59 years) groups according to the age. A statistical analysis was performed on vascular risk factors for patients with MIS and CAS, and a correlation analysis was performed on the association between SPI-Ⅱ score and CAS degree. Results CAS was found in 331 (82.34%) out of 402 cases of MIS. Intracranial, extracranial, and intra-and extracranial stenosis were present in 141 cases (42.60%), 77 cases (23.26%), and 113 cases (34.14%), respectively; mild, moderate, and severe stenosis or occlusion was present in 111 cases (33.53%), 63 cases (19.03%), and 157 cases (47.43%), respectively. The young, middle-aged, and elderly groups had 25 cases (7.55%), 107 cases (32.33%), and 199 cases (60.12%) of CAS, respectively; the middle-aged and elderly groups together had 233 cases of intracranial CAS, and the young group had 21 cases of intracranial CAS. A univariate logistic regression analysis based on presence or absence of vascular risk factors for CAS in either group revealed significantly increased age, proportion of patients with a history of diabetes, hyperlipidemia, or hyperhomocysteinemia, systolic blood pressure, and D-dimer level, but significantly reduced high-density lipoprotein cholesterol (HDL-C) level in the CAS group (P<0.05). A multivariate logistic regression analysis showed significantly increased age, proportion of patients with a history of diabetes, hyperlipidemia, or hyperhomocysteinemia, and D-dimer level, but significantly reduced HDL-C level in the CAS group (odds ratio[OR]=1.053, 95% confidence interval[CI]:1.027-1.079, P<0.001; OR=2.418, 95%CI:1.107-5.284, P=0.027; OR=2.289, 95%CI:1.204-4.353, P=0.012; OR=2.071, 95%CI:1.129-3.796, P=0.019; OR=3.446, 95%CI:1.243-9.554, P=0.017; OR=0.358, 95%CI:0.136-0.942, P=0.037). The proportion of patients with intracranial artery stenosis was significantly higher in the middle-aged and elderly groups than in the young group (χ²=4.261,P=0.039). There was a significantly positive correlation between SPI-Ⅱ score and CAS degree (r_s=0.108, P=0.031). Conclusions More than 80% of patients with MIS have CAS (mainly intracranial stenosis); the CAS distribution varies between different age groups, with intracranial artery stenosis as the dominant type identified in the middle-aged and elderly groups. In addition to indices such as age, blood pressure, blood glucose, and blood lipids, homocysteine and D-dimer are also noteworthy risk factors for CAS in patients with MIS. SPI-Ⅱ score may be of great value in predicting CAS in patients with MIS.