Objective To explore the development trajectories of cognitive function in patients with acute ischemic stroke and its latent class predictors. Methods Cluster convenience sampling was used to enroll acute ischemic stroke patients (n＝128) who were hospitalized in Neurovascular Center of The First Affiliated Hospital of Naval Medical University and Stroke Center of Air Force Hospital of PLA Eastern Theater Command from Jun. 2019 to Mar. 2020. Montreal cognitive assessment (MoCA) was used to assess the cognitive function of the patients, and baseline data (such as demographic data, disease-related data, and cognitive function) were collected during the acute hospitalization period. The cognitive function was assessed 3 and 6 months after stroke. Latent growth mixture modeling was used to identify cognitive function development trajectories, and multiple logistic regression was used to analyze predictors of different classes of development trajectories. Results Three latent classes of cognitive function development trajectories were identified in patients with acute ischemic stroke: high-level cognitive maintenance group (n＝98, 76.6%), low-level cognitive improvement group (n＝20, 15.6%), and medium-level cognitive decline group (n＝10, 7.8%). Multiple logistic regression analysis showed that education level, marital status and dysphagia were independent predictors of cognitive function development trajectories in acute ischemic stroke patients (all P＜0.05). Conclusion There is heterogeneity in the development trajectories of cognitive function in acute ischemic stroke patients, and medical staff can conduct personalized evaluation and intervention based on the influencing factors of different classes of cognitive function development trajectories.