Objective To investigate the association between leukoaraiosis (LA) and early neurological deterioration (END) in patients with acute ischemic stroke.Methods Clinical data of 328 patients with acute ischemic stroke admitted in the hospital from January 2013 to January 2016 were retrospectively reviewed.According to the changes of National Institute of Health Stroke Scale (NIHSS) scores within 72 h after admission,88 patients (26.8%) were identified as END.Clinical manifestations,laboratory tests and radiographic findings were compared between END group and non-END group.ResultsUnivariate analysis indicated that age [(74.6±11.0) vs.(70.7±11.8) years,t=2.67,P=0.01],female sex [51.1% (45/ 88) vs.38.8%(93/240),χ2=4.05,P=0.04],initial NIHSS [M(Q1,Q3) 6(3,9) vs.3 (2,6),χ2=-4.38,P=0.00],systolic blood pressure [(155±28) vs.(149±20) mmHg(1 mmHg=0.133 kPa),t=2.04,P=0.04],responsible artery occlusion [18.2% (16/88) vs.8.3%(20/240),χ2=6.39,P=0.01],white cell count [(7.8±2.7) 109 vs.(7.1±2.2) 109,t=2.32,P=0.02],fasting blood glucose [(7.2±2.6) vs.(6.6±2.4) mmol/L,t=2.00,P<0.05] and C-reactive protein level [(24.5±27.1) vs.(14.6±23.2) g/L,t=3.25,P=0.00] were significantly different between END group and non-END group.After adjustment of confounding factors,LA in periventricular with Fazekas grade 2 (OR=2.309,95%CI: 1.070-4.984,P=0.03) and Fazekas grade 3 (OR=2.861,95%CI: 1.214-6.742,P=0.02) and LA in centrum semiovale with Fazekas grade 3 (OR=3.047,95%CI: 1.244-7.461,P=0.02) were independently associated with END.Conclusion Leukoaraiosis in periventricular group and centrum semiovale are associated with early neurological deterioration in patients with acute ischemic stroke.