Objective: To explore the diagnostic value of contrast-enhanced transesophageal echocardiography (c-TTE) and contrast-enhanced transcranial doppler (c-TCD) in patients with cryptogenic stroke with patent foramen ovale (PFO). Methods: 102 patients with cryptogenic stroke who were diagnosed and treated in our hospital from January 2020 to December 2022 were selected. All patients underwent c-TCD examination and right heart contrast echocardiography. Transesophageal echocardiography (TEE) was used as the diagnostic gold standard. The diagnostic value of right heart contrast echocardiography and c-TCD examination for PFO in patients with cryptogenic stroke was compared. Results: TEE examination confirmed 44 cases of PFO in 102 patients with concealed stroke. The results of c-TCD examination showed that 36 cases were true positive, 10 cases were false positive, 8 cases were false negative, and 48 cases were true negative; The results of c-TTE showed that there were 42 cases of true positive, 3 cases of false positive, 2 cases of false negative and 55 cases of true negative. The analysis of the working characteristic (ROC) curve of the subjects showed that the AUC of c-TCD and c-TTE in the diagnosis of PFO in patients with occult stroke were 0.823 and 0.951 respectively, and the sensitivity, specificity and accuracy of c-TCD in the diagnosis of PFO in patients with occult stroke were 81.82%, 82.76% and 82.35% respectively, which were significantly lower than 95.45%, 94.83% and 95.10% of c-TTE (P<0.05). The semi-quantitative grading of right-to-left shunt by c-TCD was lower than that of c-TTE (P<0.05), and the detection rate of right-to-left shunt by c-TCD was 30.39%, significantly lower than 58.82% of c-TTE (P<0.05). Conclusion: Compared with c-TCD, c-TTE has higher diagnostic value for cryptogenic stroke patients with PFO, and the degree of semi-quantitative grading of right-to-left shunt is higher and the detection rate is higher for cryptogenic stroke patients with PFO.