Abstract: Objective To evaluate the cerebral perfusion situation of the patients with ischemic and hemorrhagic moyamoya disease using arterial spin labeling. Methods Thirty-three patients with moyamoya disease, including 12 males and 21 females, aged 10-60 years old, were selected from our hospital in 2018. All patients underwent convention MRI (T1WI, T2WI, T2-FLAIR), susceptibility weighted imaging (SWI) and arterial spin labeling imaging (ASL). According to the MRI and SWI images, the patients were divided into ischemic group (16 patients) and hemorrhagic group (17 patients). CBF values in the lesion area and contralateral brain tissue were obtained, and the differences between the two groups under different post-labeling delay (PLD) settings were compared. Results When PLD=1.5 s, there were no significant differences in the CBF between two groups (ischemic 16.36±4.46 vs. hemorrhagic 17.43±4.96, t=0.649, P=0.521). When PLD=2.5 s, there were significant differences between the two group (ischemic 35.56±10.75 vs. hemorrhagic 25.97±11.04, t=2.528, P=0.017). Conclusion Arterial spin labeling perfusion imaging with different PLD times can evaluate cerebral blood perfusion in patients with different types of moyamoya disease and provide objective basis for clinicians to select appropriate treatment methods and predict outcomes.