To explore the clinical application of three-dimensional arterial spin labeling (3d-asl) and magnetic resonance diffusion imaging (DWI) in transient ischemic attacks. 40 patients with transient cerebral ischemia in our hospital were selected and included from July 2020 to March 2022. All subjects were detected by DWI and 3D-ASL technology. The positive rate, rCBFand the ROC curve of the two methods in the diagnosis of transient cerebral ischemia were compared; Objective was to compare the relationship between the frequency of transient ischemic attack and hypoperfusion, and vascular stenosis. The 3D-asl examination showed 2 cases of hypoperfusion in the healthy control group (5.00), and the MRI examination showed 4 cases of vascular stenosis in the healthy control group (10.00). The rCBF ratio in the cerebral ischemia group was significantly lower than that in the cerebral ischemia group, which was significantly lower than that in the healthy control group (P < 0.05). The area under the curve (AUC) of 3d-asl in the diagnosis of transient cerebral ischemia was 0.800, and the AUC of DWI in the diagnosis of transient cerebral ischemia was 0.725. The AUC of the combination of the two methods in transient cerebral ischemia was 0.850. There was a significant difference in the attack frequency of patients with transient cerebral ischemia with different perfusion (P < 0.05). There was a significant difference in attack frequency between patients with transient ischemic attack and patients without vascular stenosis (P < 0.05). 3D-asl and DWI technology has higher diagnostic efficiency for transient cerebral ischemia.