Intracranial branch atheromatous disease (BAD) includes infarcts in the territories of the lenticulostriate arteries (LSA) and paramedian pontine arteries (PPA). The two subtypes of BAD are commonly underused in clinical practice and research. We assessed the clinicoradiologic characteristics of BAD-stroke patients in LSA territories and compared with those of BAD-stroke patients in PPA territories to investigate whether there is a close relationship between leukoaraiosis (LA) and BAD in Southern Han Chinese patients. According to the lesions present in different vascular distributions as shown by diffusion-weighted imaging (DWI), a total of 220 patients diagnosed with BAD, selected from a cohort of 1,458 consecutive patients with acute ischemic stroke, were classified into LSA and PPA groups, comprising 163 and 57 patients, respectively. The characteristics of the patients with BAD were analyzed and differences between the two groups were compared. A high prevalence of concomitant LA (n = 190, 86.36 % of patients with BAD) was observed in the cohort study. Patients in the PPA group had a significantly higher National Institutes of Health Stroke Scale (NIHSS) score on admission than those in the LSA group [6 (4-8) versus 5 (3-7); p = 0.031], and there was a higher prevalence of concomitant LA in the PPA group than the LSA group (96.4 versus 82.8 %; p = 0.010). Conversely, when the number of patients with LA grades ≥ 4 was evaluated, individuals in the LSA group were more frequently affected than those in the PPA group (47.9 versus 31.6 %; p = 0.033). LA showed a high prevalence in Southern Han Chinese patients with BAD. Patients in the LSA group were significantly different from those in the PPA group with respect to NIHSS score, LA and LA grade.