Objective To investigated the effect of the risk factors for stroke on the development of leptomeningeal colateral circulation in patients with middle cerebral artery occlusion. Methods Patients with acute ischemic stroke confirmed as middle cerebral artery occlusion by imaging were extracted from the Nanjing Stroke Registry Program between June 2006 and December 2011. The baseline clinical data were colected. Leptomeningeal colateral circulation was assessed by angiography. Results A total of 137 patients were enroled, including 100 males and 37 females; mean age 55. 26 ± 11. 71 years. The colateral circulation of 65 patients (47. 4% ) was good. Univariate analysis showed that the ages (52. 3 ± 13. 2 years vs. 57. 9 ± 9. 5 years; t = 2. 866, P = 0. 005) and the proportion of hypertension (52. 3% vs. 70. 8% ; χ2 = 4. 978, P =0. 026) in the good colateral circulation group were significantly lower than those in the poor colateral circulation group. Multivariate logistic regression analysis showed that age was an independent risk factor for affecting the leptomeningeal colateral circulation in patients with acute middle cerebral artery occlusion (odds ratio, 0. 965, 95% confidence interval 0. 934-0. 997, P = 0. 034). Conclusions Age is an independent risk factor for affecting the leptomeningeal colateral circulation in patients with middle cerebral artery occlusion.