Inflammation plays an important role in the development, progression, and rupture of the atheromatous plaque. Blood inflammatory markers such as high sensitivity CRP (hs-CRP) can predict not only myocardial infarction but also cerebral infarction in the later life. Recent histological examinations showed that plaque rupture causes vascular accident in the brain in both extracranial and intracranial arteries. Inflammatory cells in the carotid atheromatous plaque are known to express proinflammatory cytokines, chemokines, and inflammatory enzymes. Levels of inflammatory markers in the blood are associated with plaque progression and echogenicity in the carotid artery and severity and progression of intracranial larger artery and small cerebral vessel diseases such as silent infarction and white matter lesions. Anti-inflammatory treatment for blood vessel might be a promising strategy for the primary and secondary prevention for cerebral infarction.