Objective To investigate the risk factors of cognitive impairment in patients with acute ischemic stroke (AIS). Methods A total of 100 AIS patients in Neurovascular Center, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Aug. to Dec. 2022 were enrolled. According to the mini mental status evaluation (MMSE) score, the patients were divided into normal cognitive group (59 cases) and impaired cognitive group (41 cases). The basic clinical data, laboratory and imaging examination data, Montreal cognitive assessment (MoCA), patient health questionnaire-9 (PHQ-9), Lubben social network scale (LSNS-6) and University of California, Los Angeles loneliness scale-version 3 (UCLA-3) of the patients in the 2 groups were collected. Binary logistic regression model was used to analyze the risk factors of cognitive impairment in AIS patients. Results Compared with the normal cognitive group, the impaired cognitive group was older (P＝0.012), had lower level of education (P＝0.045), higher proportion of diabetes mellitus history (P＝0.026), and lower MMSE score (P＜0.001), MoCA score (P＜0.001) and LSNS-6 score (P＝0.012), and higher PHQ-9 score (P＜0.001) and UCLA-3 score (P＝0.002). Moreover, there was significant difference in Oxfordshire Community Stroke Project (OCSP) classification (P＝0.031) between the 2 groups. Binary logistic regression analysis showed that age (odds ratio ［OR］ ＝1.070, 95% confidence interval ［CI］ 1.020-1.123, P＝0.005) and total anterior circulation infarct (OR＝55.633, 95% CI 2.041-1 516.526, P＝0.017) were risk factors for cognitive impairment in AIS patients. Conclusion Age and total anterior circulation infarct are risk factors of cognitive impairment in AIS patients.