Objective: To compare between 3D TOF MRA 3.0T technique with DSA in diagnosing intracranial atheroslerotic stenosis and occlusive disease. Subject and method: 153 arterial segments of 17 ischemic patients due to intracranial atherosclerosis were diagnosed and treated at the Stroke Center in the No.108 Military Central Hospital from 2013 to 2014. The authors compared the degree of stenosis on 3D TOF MRA 3.0 T and DSA. The measured percentage of diameter stenosis was categorized as follows: Low grade stenosis (normal) 50 percent, high grade stenosis 50 - 99 percent, complete occlusion 100 percent. Result: 153 arterial segments of 17 ischemic patients were examined. There were 33 steno-occlusive arterial segments on QSA and 30 steno-occlusive arterial segments on TOF MRA 3.0T. 3D TOF - MRA 3T assessed the high grade stenosis arteries with the sensitivity of 72.7 percent, the specificity of 97.7 percent, the positive predictive value of 84.21 percent, and the negative predictive value of 94.81 percent. 3D TOF - MRA 3T assessed of the complete occlusive arteries with the sensitivity of 64.28 percent , the specificity of 98.56 percent, the positive predictive value of 81.81 percent and the negative predictive value of 96.47 percent. Conclusion: High-resolution 3D TOF-MRA with sensitivity encoding at 3T can be used as a reliable diagnostic tool for the detection of intracranial stenosis and occlusive disease.