Aim To investigate the association of activated coagulation factor Ⅶ (FⅦa) and its gene MspI polymorphism for cerebral infarction with hypertension in Chinese. Methods This study was performed with the method of candidate gene and case-control study. FⅦ genotypes were identified with polymerase chain reaction amplified genomic deoxyribonulieic acid (DNA) and MspI restriction fragment length polymorphism analysis,and plasma FⅦa levels were detected with recombinant tissue factor method in 149 hypertensive patients, 132 hypertensive patients with ischemic stroke (stroke group) and and 148 normotensive sex- and age- matched control subjects. Results Plasma FⅦa levels were significantly higher in patients with ischemic stroke than those of patients with hypertension (2.78±0.59 v.s 2.53±0.62 μg/L, p<0.05). FⅦa is a risk factor for ischemic stroke with hypertension on Logistic regression analysis.(Or=1.134, p<0.05). The allelic frequencies were in Hardy-Weinberg equilibrium. The results suggested that the distribution of genotype and allelic frequencies in every group had no significant difference, also no difference in subgroups of ischemic stroke (p>0.05). FⅦa levels were significantly higher in Arg homozygotes than in Gln allele carriers (2.72±0.60 v.s 1.98±0.59 μg/L, p<0.05)and associated with FⅦ gene polymorphism. Conclusions Plasma FⅦa levels may be an important risk factor of cerebral infarction with hypertension and the levels are influenced by MspI polymorphism of the FⅦ gene.