Aim To study the relationship between ankle-brachial index(ABI) and ischemic stroke in Chinese patients. Methods ABI was measured in patients from hospitals of Shanghai and Beijing. Results Patients with ischemic stroke were significantly older than that of with non-stroke(70.29±10.01 years vs 65.89±11.87 years,p<0.001).The low ABI was significantly more common in ischemic stroke group than non-stroke group(34.6% vs 20.9%,p<0.001).After adjusting other risk factors of ischemic stroke,the patients with ABI≤0.9 were more than 1.55 times likely to get ischemic stroke than those with ABI>0.9(95% CI: 1.314～1.817).The incidence of ischemic stroke increased significantly as ABI level decreased. Conclusions Low ABI is associated with increased incidence of ischemic stroke.Simple measurement of ABI in patient could be a useful tool for evaluating the risk of ischemic stroke.