Abstract: Objective To explore the effect of hypersensitive troponin I(hs-TnI) on the prognosis of patients with acute ischemic stroke and its predictive value. Methods A total of 100 patients with acute ischemic stroke who were admitted to the Department of Neurology, the People's Hospital of Zhuji from January to March 2018 were included as the objects of study retrospectively. According to the mRS score of 90 days follow-up, the patients were divided into good prognosis(mRS 0-2) group and poor prognosis(mRS 3-6). Clinical data and laboratory examination indicators of all patients before treatment were compared. The relationship between hs-TnI level and 90-day prognosis was analyzed by binary logistic regression. The predictive value of hs-TnI in the prognosis of patients with acute ischemic stroke was analyzed by receiver operating curve(ROC). Results The age, female ratio, NIHSS score, proportion of disease history, systolic blood pressure and hospitalization time in poor prognosis group were significantly higher than those in good prognosis group(all P<0.05). There were no significant differences in proportion of disease history, smoking history, diastolic blood pressure, heart rate, and the levels of fasting blood glucose, low density lipoprotein and serum creatinine between two group(all P>0.05). The leucocyte count and hs-TnI in the poor prognosis group was significantly higher than that in the good prognosis group(all P<0.05). The levels of hemoglobin and hematocrit were significantly lower than those in the good prognosis group(all P<0.05). The results of binary logistic regression analysis showed that women, age, history of stroke, NIHSS score at admission and hs-TnI were independent risk factors for poor prognosis, while hemoglobin was a protective factor for good prognosis(all P<0.05). The AUC value of hs-TnI was 0.818. Conclusion The increase of hs-TnI is an independent risk factor for patients with acute ischemic stroke.