Objective: This paper aimed to investigate the predictive values of left atrial appendage (LAA) function and carotid atherosclerotic plaques (CAPs) for ischemic stroke (IS) in patients with nonvalvular atrial fibrillation (NVAF). Methods: Data were retrospectively collected from 40 patients with NVAF complicated by IS (stroke group) and 160 patients with NVAF not complicated by IS (non-stroke group) during the same period. The basic data of the two groups were collected, CHA2DS2-VASc scoring was performed, and the diameter, depth, morphology, and function of the LAA (LAA peak) emptying velocity (LAA-PEV) and LAA peak filling velocity (LAA-PFV) were examined in the two groups using transesophageal echocardiography. The presence of CAPs was examined using transcranial Doppler ultrasonography. Univariate and multivariate logistic regression analyses were used to analyze the independent risk factors for IS in patients with NVAF. Spearman's correlation analysis was performed to investigate the relationship between LAA-PEV, LAA-PFV, and CAPs and the occurrence of IS in patients with NVAF. Finally, receiver operating characteristic (ROC) curves and the Delong test were used to analyze the predictive value of LAA function (LAA-PEV, LAA-PFV) and CAPs alone or in combination for the occurrence of IS in patients with NVAF. Results: Univariate analysis revealed that age, CHA2DS2-VASc score, and CAP incidence were higher in the stroke group than in the non-stroke group, while a history of anticoagulant drug use, LAA-PEV, and LAA-PFV were lower in the stroke group than in the non-stroke group (p < 0.05). Logistic regression analysis revealed that a higher CHA2DS2-VASc score and the presence of CAPs were independent risk factors for the occurrence of IS in patients with NVAF (odds ratio (OR) >1, p < 0.05) and history of anticoagulant drug use as well as higher LAA-PEV and LAA-PFV were protective factors against IS in patients with NVAF (OR <1, p < 0.05). Correlation analysis revealed that LAA-PEV and LAA-PFV were negatively linked (r = –0.373, –0.361, p < 0.05). In contrast, CAPs were positively related to IS in patients with NVAF (r = 0.310, p < 0.05). The area under the ROC (AUC-ROC) curve of LAA-PEV, LAA-PFV, CAPs, and combined examination to predict the occurrence of IS in patients with NVAF were 0.769, 0.761, 0.694, and 0.890, respectively. The area under curve (AUC) of the combined assessment was greater than that of the individual examinations of LAA-PEV, LAA-PFV, and CAPs (p < 0.05). Conclusion: LAA function and CAPs are closely associated with the occurrence of IS in patients with NVAF, and their combined examination has good predictive value for the occurrence of IS in patients with NVAF.