Abstract: Objective To analyze the effects of anemia on clinical presentations and prognosis of patients with acute ischemic stroke. Methods Two hundred and sixty-seven patients with acute ischemic stroke were selected and divided into anemia group (n=85) and non-anemia group (n=182). Of the 267 cases, 140 cases were male (52.4%) and 127 cases (47.6%) were female with the mean age of 69.0 years old. Clinical presentation and characteristic were recorded and compared between two groups. Stroke recurrence and mortality were recorded and compared after the 2-year follow-up. Results The age, blood glucose, incidence of coronary disease, chronic renal insufficiency, duration in hospital and mortality in 2 years of anemia group were significantly higher than those in nonanemia group, while the hemoglobin and hyperlipidemia was significantly lower than those in non-anemia group (P＜ 0.05). Logistic regression analysis showed that anemia was a risk factor for 2 years prognosis after acute ischemic stroke with OR of 1.438, which suggested that under the same conditions, patients with anemia had 1.682 times of risk to get a worse prognosis compared with nonanemia patients. Conclusion There is no significant difference between patients with and without anemia in clinical presentations, but anemia is an independent risk factor for prognosis after acute ischemic stroke.