A total of 94 patients aged 80 years or over diagnosed as acute ischemic stroke based on their clinical features and CT or MRI and 64 elderly people without stroke as controls were enrolled in this study. They were admitted in Beijing Hospital from September 2003 to July 2008. Blood pressure measurement, electrocardiogram (ECG) and color doppler ultrasonography in carotid arteries were performed for all of them, as well as blood glucose, lipid and fibrinogen were measured and history of hypertension,diabetes, coronary heart disease, hyperlipidemia, smoking and alcohol drinking were recorded. Univariate analysis showed that more hypertension, hyperfibrinogenemia, atrial fibrillation and carotid atherosclerosis were found in the elderly patients with ischemic stroke than in those without it ( P ＜ 0. 05 ). And, multivariate logistic regression analysis showed that hyperfibrinogenemia ( OR = 16. 23, P = 0. 009 ), atrial fibrillation ( OR = 3.47, P = 0. 080) and isolated systolic hypertension ( OR = 1.05, P ＜ 0. 01 ) all were independent risk factors for ischemic stroke in the elderly.