Objective To analyze the imaging characteristics of patients with recurrence of acute cerebral ischemic stroke,select and predict relevant imaging factors,to guide clinical treatment and prevention.Methods Data of 30 patients with acute cerebral ischemic stroke (recurrent group)and 40 patients with primary cerebral ischemic stroke (non recurrent group)were collected.Imaging characteristics of first onset of recurrent group and non recurrent group were analyzed.Leukoaraiosis,a large area of infarction,cortical infarction,carotid artery plaque,arteriosclerosis,incomplete Willis ring,watershed infarction and other risk factors were screened,to determine the association between these risk factors and recurrent cerebral ischemic stroke.Results Recurrence of cerebral ischemic stroke was associated with leukoaraiosis,carotid artery plaque and incomplete Willis ring (P values were 0.024,0.021,0.003).There was no correlation between recurrence of cerebral ischemic stroke and a large area of infarction,cortical infarction,arteriosclerosis and watershed infarction (P values were 0.233,0.945,0.072,0.375).Conclusion Leukoaraiosis,carotid artery plaque and incomplete Willis ring may be risk factors for recurrence of cerebral ischemic stroke.Those signs can provide imaging evidence for secondary prevention of cerebral ischemic stroke.