Besides the assessment of carotid artery stenosis, evaluation of the vascular anatomy and lesions within both the extra- and intracranial arteries is crucial for proper clinical evaluation, treatment choice and planning. The purpose of our study was to evaluate the potential of dual-source CTA and 3T-MRA. In 16 symptomatic CAS patients, contrast-enhanced DSCT and 3T-MRA examinations were performed. For DSCT a dual-energy protocol with a 64 x 0.6-mm collimation was applied. In 3T-MRA intracranial high-resolution unenhanced TOF and extracranial contrast-enhanced MRA were performed. All examinations were analyzed for relevant morphologic and pathologic features or anomalies, and a total of 624 vessel segments were scored. All examinations were of diagnostic image quality with good to excellent vessel visibility. Almost all intracranial arteries were significantly better visualized by MRA compared to CTA (five of six vessels, p < 0.05). DSCT however allowed for further morphological carotid stenosis description, especially with respect to calcification. Although MRA proved to be superior in visualization of smaller intracranial arteries, all pre-interventionally relevant information could be perceived from DSCT. DSCT and MRA may both be regarded as a reliable, fast, pre-interventional imaging investigation in patients with carotid artery stenosis.