Objective To explore the influencing factors of microembolic signal in patients with acute cerebral infarction and its relationship with short-term prognosis. Methods A total of 118 patients with acute cerebral infarction admitted to the Neurology Department of the Second Affiliated Hospital of Wannan Medical College from January 2019 to January 2020 were prospectively enrolled as the research objects. All of them were monitored by transcranial Doppler for microembolic signals. According to whether the microembolic signals were positive， they were were divided into positive group and negative group. Uni-variate and multivariate logistic regression were used to analyze the influencing factors of microembolic signal； After 6 months of follow-up， the recurrence of cerebral infarction was observed. The relationship between the positive microembolic signal and the recurrence of cerebral infarction was analyzed by Kaplan-Meier survival curve. Rusults There were 36 of the 118（ 30.51%） patients with acute cerebral infarction had positive microembolic signals. Carotid artery plaque ［69.44%（ 25/36）］， severe stenosis rate of carotid artery［ 55.56%（ 20/36）］， platelet（ PLT）［ （278.84±26.93）×109/L］， high sensitivity C-reactive protein（ hs-CRP） level［ （13.87±3.58） mg/L］， and the National Institutes of Health Stroke Scale（ NIHSS） score（ 5.93±1.17） in the positive group were significantly higher than those in the negative group［ 29.27%（ 24/82）， 20.73%（ 17/82），（ 215.48±16.53）×109/L，（ 9.87±2.07） mg/L， （4.88±0.58）］； high-density lipoprotein cholesterol（ HDL-C） level in the positive group［ （0.91±0.33） mmol /L］ was lower than that of the negative group［ （1.23±0.65） mmol/L］. The differences were statistically significant （all P＜0.05）. According to multivariate logistic regression analysis results， carotid artery plaque（ OR=7.425， 95%CI： 2.892-28.882）， severe stenosis（ OR=2.692， 95%CI：1.362-8.736）， and high PLT level（ OR=8.462， 95%CI：1.425-16.465） were all independent risk factors of positive microembolic signals（ all P ＜ 0.05）. All patients were followed up， and 15 cases of cerebral infarction recurred， of which the positive group was 22.22% （8/36）， higher than 8.54%（ 7/82） of the negative group. The difference was statistically significant（ χ2=4.223， P=0.040）. Kaplan-Meier survival curve analysis and Log-rank test showed that patients in positive group were more likely to have cerebral infarction recurrence than those in negative group（ P＜0.05）. Conclusions The positive microembolic signals in patients with acute cerebral infarction are related to carotid plaque， severe stenosis and high level of platelets， suggesting that these patients have a worse short-term prognosis and require closer follow-up to strictly control risk factors.