Abstract: Objective To explore the relationship between family factors and recurrence of ischemic stroke. Methods A total of 121 patients with acute ischemic stroke hospitalized in the Department of Neurology, the Second Affiliated Hospital of Zhejiang Chinese Medical University from June 2015 to May 2016 were followed up for 2 years. The patients were divided into poor prognosis group and good prognosis group according to recurrence. Family and clinical data of the patients were collected. Family intimacy and adaptability scale was used to evaluate patient's families, and stroke knowledge was assessed for the primary caregivers. The influence of family and clinical factors on the recurrence of ischemic stroke was analyzed by logistic regression. The relationship between family factors and clinical features of patients was analyzed by Pearson correlation analysis. Results The proportion of patients in poor prognosis group from rural areas? imbalanced families and families with large population was higher than that in good prognosis group, while the education, the average family income and the knowledge level of primary caregivers in poor prognosis group were lower than that in good prognosis group(all P<0.05). Logistic regression analysis showed that in family factors low education level of patients, low average family income, poor stroke knowledge of primary caregiver and imbalanced type of families were independent crisis factors for poor prognosis in ischemic stroke. The stroke knowledge level of primary caregivers was negatively correlated with the patient's LDL-C level(r=-0.793, P=0.018). Conclusion In family factors, low education level, low average family income, poor stroke knowledge of primary caregivers and imbalanced family type are independent risk factors for recurrence of ischemic stroke. The less the primary caregiver knows about stroke, the higher the patient has LDL-C level.