Objective To clarify the incidence rates of large-vessel stenosis or occlusion in patients with diffusion-weighted imaging （DWI）-negative cerebral infarction. Methods A total of 46 patients with DWI-negative cerebral infarction （DWI-negative group） and 357 patients with DWI-positive cerebral infarction （DWI-positive group） who were hospitalized in the Department of Neurology of our hospital were selected. The clinical data， hematology test results， and brain magnetic resonance angiography results of these patients were recorded. Results Compared with patients in the DWI-positive group， patients in the DWI-negative group had significantly higher proportions of hemiataxia and advanced cortical dysfunction， and a significantly lower proportion of aphasia （ P<0.05）. There was no significant difference in National Institutes of Health Stroke Scale score and modified Rankin scale score on D ₁， D ₇ and D ₁₄ between the DWI-negative group and the DWI-positive group （ P>0.05）. The triglyceride and folic acid levels in the DWI-negative group were significantly lower than those in the DWI-positive group （ P<0.05）. The proportion of anterior cerebral artery， internal carotid artery （C ₂-C ₇ segment）， and posterior cerebral artery stenosis or occlusion in the DWI-negative group was significantly lower than that in the DWI-positive group （ P<0.05）. There was no significant difference in the total number of intracranial arteries with stenosis or occlusion between the DWI-positive group and the DWI-negative group （ P>0.05）. There was no significant difference in the total number of common carotid artery internal carotid artery （C ₁ segment）， vertebral artery （V ₁-V ₂ segment） and extracranial vessels with stenosis or occlusion between the DWI-negative group and the DWI-positive group （ P>0.05）. Conclusions The probability of developing large intracranial and extracranial vessel stenosis or occlusion in DWI-negative cerebral infarction may not be lower than in DWI-positive cerebral infarction.