Objective: To explore the value of contrast transcranial Doppler (c-TCD) in the diagnosis of patent foramen ovale and evaluation of the efficacy of closure. Methods: A total of 145 patients with cryptogenic stroke or migraine who were screened as grade IV positive by c-TCD were underwent transesophageal echocardiography (TEE). Patients with indications for transcatheter closure were treated with interventional surgery and followed up. Results: Among the patients with cryptogenic stroke or migraine whose c-TCD screening was grade IV positive, 144 cases were confirmed as patent foramen ovale by percutaneous transcatheter intervention. TEE was definitely diagnosed in 115 (79.9%) of 144 patients. For 106 patients with permanent right-to-left shunt(RLS), 87 patients were observed with PFO by TEE, with a diagnostic sensitivity of 82.1%; for 38 patients with latent RLS, 28 patients were observed with PFO by TEE, with a diagnostic sensitivity of 73.7%. Statistical analysis showed that there was no significant difference in the positive rate of TEE test between the two groups (χ 2=1.225, P=0.268), indicating that there was PFO of RLS, and there was no difference in diagnostic sensitivity of TEE whether RLS occurred at rest or Valsalva. Binary Logistic regression analysis indicated that c-TCD result after patent foramen ovale closure was an independent risk factor for postoperative symptoms (P<0.05). Conclusion: c-TCD can be used to screen the etiology of cryptogenic stroke or migraine patients with patent foramen ovale, and it is a good method to evaluate the efficacy of patent foramen ovale in patients receiving catheterization therapy.