Abstract: Objective To summarize the surgical treatment outcomes of patients with infective endocarditis (IE) complicated by cerebrovascular accident (CVA). Methods A retrospective analysis of clinical data about 42 patients diagnosed with IE complicated by CVA in our hospital from June 2005 to September 2015 was conducted. There were 26 males and 16 females with the mean age of (39.9±16.7) years (ranging from 9 to 71 years). Of the 42 cases, 10 cases were single aortic valvular disease, 24 cases with single mitral valvular disease, 6 cases with multiple valvular disease, and 2 cases with left atrial myxoma. Types of CVA consisted of cerebral infarction (n=32) and cerebral hemorrhage (n=10, including 6 concurrent cerebral infarction). Totally 46 valves were involved, 22 cases had mechanical valve replacement, 16 had biovalve replacement, 6 had mitral valve repair, 10 had tricuspid valve repair and 2 had left atrial myxoma resection. Results The average day between new-onset CVA and surgery was 65 d. Sixty-six vegetations were found intraoperatively with the mean maximum size of 13.9 mm. Of the 42 patients, 6 patients had cerebrovascula accident post-operatively and one of them died because of severe CVA. Thirty-three patients were followed up (80.4%) with the duration of 11.9-127.7 months. Of the 33 cases, 4 had cerebral infarctions including one who died of multiple cerebral infarction One underwent Bentall surgery because of dissecting aneurysm whose cardiac function corresponded to New York Heart Association class Ⅲ after surgery. Conclusion IE patients with CVA should accept surgical treatment, and head CT scan and hemagglutinin should be emphasized after surgery.