Objective:To investigate the predictive value of negative result of susceptibility vessel sign (SVS) in etiology types of large vessel occlusion (LVO) stroke.Methods:Sixty-three LVO stroke patients admitted to our hospital from December 2015 to October 2019 were chosen in our study. The clinical data of 63 patients with negative SVS and positive SVS were compared to clarify the independent factors influencing the SVS negative/positive results. The SVS negative rate in large artery atherosclerosis (LAA) patients and non-LAA patients were compared, and the sensitivity, specificity and accuracy of SVS in predicting LAA acute middle cerebral artery occlusion were evaluated.Results:Of the 63 patients, 32 (50.8%) had negative SVS, and 31 had positive SVS; as compared with the positive SVS group, the negative SVS group had significantly higher incidence of hyperlipidemia, lower baseline NIHSS scores, and lower incidence of atrial fibrillation ( P<0.05). Multivariate Logistic regression analysis showed that hyperlipidemia and baseline NIHSS scores were independent factors influencing SVS in patients with LVO stoke. Among the 41 LAA patients, 25 had negative SVS, with a negative rate of 61.0%; among the 22 non-LAA patients, 7 had negative SVS, with a negative rate of 31.8%; significant difference in negative rate was noted between the two groups ( χ2=4.870, P=0.027). The sensitivity, specificity, positive and negative predictive values, and accuracy of negative SVS in predicting LAA stroke was 60.98% ( 95%CI: 44.50%-75.80%), 68.18% ( 95%CI:45.13%-86.14%), 78.12%, 48.39% and 63.49%, respectively. Conclusion:Negative result of susceptibility vessel sign has a high predictive value in acute middle cerebral artery occlusion.