Objective <p>To investigate the correlation between carotid plaque calcification types and recurrent stroke using computed tomography angiography (CTA). Additionally, a conjoint analysis was conducted to explore the physical activity, appetite, sleep, and mood of the patients as variables, to provide a novel reference for the clinical treatment and management of ischemic stroke.</p> Method <p>Patients who underwent head and neck CTA scans and were diagnosed with unilateral or bilateral carotid plaques with stenosis &lt; 70% at the First People’s Hospital of Lianyungang from September 2022 to August 2023 were enrolled in this study. They underwent 2 to 3 years of follow-up. Patients meeting the inclusion criteria were classified into 1 to 6 types based on plaque calcification characteristics, to analyze differences in recurrent stroke between these types.</p> Results <p>Using the eligibility criteria, 346 patients with carotid plaque were included. In the clinical baseline data, no significant differences were observed between the recurrent and the non-recurrent stroke groups. Spearman’s correlation analysis showed significant associations between plaque calcification types and recurrent stroke (<i>p</i> &lt; 0.001). Subsequently, Cox proportional hazards model analysis further demonstrated a significant correlation between plaque calcification types and clinical endpoint (HR: 1.149,95% CI: 1.059–1.247, <i>p</i> &lt; 0.001). Even after adjusting for sleep, appetite, physical activity, and mood of the patients, the plaque calcification types remained significantly associated with the clinical endpoint (HR: 1.128,95% CI: 1.037–1.226, <i>p</i> = 0.005).</p> Conclusion <p>This study indicates a correlation between carotid plaque calcification types and the recurrence of stroke. These findings provide a novel approach to reviewing carotid atherosclerotic plaque calcification and further imaging-based evidence for the risk assessment of recurrent ischemic stroke.</p>