Objective To investigate the application value of threedimsional arterial spin labeling imaging(3D-ASL)and diffusion-weighted imaging(DWI)in the differential diagnosis of acute cerebral infarction.Methods One hundred and eight patients with highly suspected acute cerebral infarction admitted to our hospital from November 2020 to December 2023 were selected,and all admitted patients received MRI scans.3D-ASL and DWI image manifestations of the patients were analyzed,and the diagnostic efficacy of 3D-ASL sequence and DWI was evaluated with comprehensive clinical diagnosis as the gold standard.Results Among 108 suspected patients,100 were positive,97 were diagnosed with acute cerebral infarction by 3D-ASL sequence,and 78 were diagnosed with acute cerebral infarction by DWI.The diagnostic coincidence rate,sensitivity and specificity of 3D-ASL were higher than those of DWI(P<0.05).Compared with 3D-ASL and DWI imaging parameters,regional cerebral blood flow(rCBF)and ADC values on lesion side were lower than those on healthy side(P<0.05).There were significant differences in 3D-ASL and DWI imaging parameters among patients in acute,subacute and chronic stages(P<0.05).Conclusion In the differential diagnosis of acute cerebral infarction,3D-ASL diagnosis coincidence rate and sensitivity are higher than DWI,which can provide a certain reference basis for clinical application,and has important reference value.