Objective To explore the relationship between risk of stroke and calcaneal quantitative ultrasound(QUS)T score under-2. 5. Methods 5 847 subjects over the age of 40 from Yunyan District, Guiyang City were investigated with questionnaire, physical examination, blood lipids, other metabolic indexes and calcaneus bone density determination from May to October, 2011 by cluster sampling method and were followed up for 3 years. Subjects were divided into stroke group(99 subjects) and non-stroke group(5 748 subjects) according to the occurrence of stroke in the follow-up period. The relationship between risk of stroke and QUS T score under-2. 5 was analyzed. Results Compared to the non-stroke group, the number of subjects with T score under-2. 5 in calcaneal QUS was larger in the stroke group, the difference of which was statistically significant(P<0. 05). T score of bone density under-2. 5 in calcaneal QUS was found to be an independent risk factor for predicting stroke after adjusting for age, sex, and body mass index(HR=1. 467, 95%CI 0. 753-2. 855). The relationship between risk of stroke and T score under-2. 5 in calcaneal QUS remained unchanged after further adjust ment of smoking, diabetes, education, and hypertension(HR=1. 265, 95%CI 0. 647-2. 475). Conclusion The risk of stroke and T score of bone density under-2. 5 in calcaneal QUS was independently associated, and the latter is an independent risk factor for predicting stroke.