Abstract: Objective To investigate the independent factors associated with the recurrence of acute ischemic stroke patients with different CYP2C19 genotypes. Methods Retrospective analysis of 601 cases of patients with acute ischemic stroke and finished the detection of CYP2C19 gene polymorphism. According to different genotypes of CYP2C19 in patients were divided into extensive, intermediate and poor metabolism of three independent groups, each group was further divided based on the results of follow-up into recurrence group and non recurrence group, clinical data were collected, analyzed their correlation with the recurrence of ischemic stroke. Results Take the index in three independent groups had significant difference into Logistic regression analysis. Albumin in extensive metabolism group(P=0.036), Triglyceride (P=0.036) and cystatin C (P=0.044) in intermediate metabolic group, blood glucose(P=0.040) and free triiodothyronine(P=0.025) had significant effects on recurrence (P < 0.05). Conclusion The related factors of recurrence of AIS patients with different CYP2C19 genotype are different. Albumin is a protective factor for recurrence in AIS patients with extensive metabolism of CYP2C19. Triglyceride and cystatin C are risk factors of recurrence in AIS patients with intermediate metabolism of CYP2C19. Blood glucose and low levels of free triiodothyronine are risk factors of recurrence in AIS patients with poor metabolism of CYP2C19