Objective: To explore the predictive value of optic nerve sheath diameter (ONSD) of ultrasound quantification and plaque characteristics for adverse events in ischemic stroke. Methods: A total of 38 patients with ischemic stroke admitted to the hospital were enrolled between December 2021 and October 2022. All were given endovascular treatment, and general data of patients were recorded. According to presence or absence of adverse events after treatment, they were divided into adverse event group (8 cases) and control group (30 cases). Results: ONSD, eccentricity index, plaque area, plaque length and enhancement amplitude in adverse event group were significantly higher than those in control group (P<0.05). The results of Logistic regression analysis showed that ONSD, eccentricity index, plaque area, plaque length and enhancement amplitude were independent influencing factors of prognosis (P<0.05). In single detection, AUC of plaque length for predicting prognosis was the greatest. Taking 5.47 as the cut-off value, its sensitivity and specificity were 100.00% and 96.67%, respectively. AUC of plaque length was significantly greater than that of plaque area (P<0.05), and AUC of plaque length was significantly greater than that of enhancement amplitude (P<0.05). Conclusion: ONSD and plaque characteristics have good predictive value for adverse events in patients with ischemic stroke after intravascular treatment.