Abstract: Objective To investigate the relationship between blood lipid level at hospital admission and adverse outcome after hospitalization in acute ischemic stroke (AIS) patients and to provide evidences for secondary prevention of AIS.Methods We conducted a retrospective cohort study in four general hospitals (two at municipal level in Anshan and Dandong city and two at county level in Liaoyang and Dawa county of Liaoning province).We extracted medical records of 1 641 patients hospitalized between January 1st and August 31st,2015 and diagnosed primarily as AIS at hospital discharge and carried up a follow-up survey to collect information on AIS-related outcome.Results Of all the AIS patients,37.7%,36.9%,and 31.0% showed high levels of total cholesterol (TC),triglyceride (TG),and low density lipoprotein cholesterol (LDL-C) and 19.0% showed a low level of high density lipoprotein cholesterol (HDL-C),respectively,at the first test after hospitalization.The score of modified Rankin Scale (mRS) was 1.46±1.79 and the proportion of with adverse outcome after hospitalization discharge was 23.3% for all the AIS patients.The results of unconditional multivariate logistic regression analysis revealed that TG level of 1.00-1.39 mmol/L and LDL-C level of 2.95-3.53 mmol/L at hospital admission exerted a short-term protective effect against adverse outcome post hospitalization after adjusting for gender,age,smoking,alcohol consumption,history of hypertension,history of diabetes and other potential confounding factors.Conclusion High levels of TG and HDL-C at hospital admission may have protective effect against short-term adverse outcomes among AIS patients.