Objective To investigate the pathogenesis of isolated ischemic stroke in basal ganglia using high resolution-magnetic resonance imaging (HR-MRI). Methods Fifteen consecutive patients with isolated ischemic stroke in basal ganglia, who received HR-MRI examination in our hospital between Jan. 2015 and Dec. 2016, were included in this study, and the clinical and imaging data were analyzed. Results Vascular evaluation results showed that 6 patients had normal middle cerebral artery, 4 had mild stenosis, 2 had moderate stenosis, and 3 had severe stenosis. HR-MRI examination showed that plaque formation of the middle cerebral artery in the lesion side was found in 10 patients, of which 7 patients had arc plaques and 3 had annular plaques. T₁ weighted imaging showed that the plaques of 8 patients were obviously enhanced, the plaque of 1 patient was moderately enhanced, and the plaque of 1 patient was not enhanced. Conclusion The etiology of isolated ischemic stroke in basal ganglia is complex. HR-MRI examination can clearly show the wall and plaque of the middle cerebral artery, providing evidence for etiological judgment.