Objective To compare the recognition ability of different prodromal symptoms of bipolar disorder （BD） among BD patients and their caregivers. Methods A retrospective survey was conducted on 80 non-acute BD patients admitted to the outpatient and inpatient departments of Beijing Anding Hospital Affiliated to Capital Medical University from March 2015 to September 2018 and 80 family members （caregivers/ guardians） who had close contact with the patients. Semi-structured interviews were conducted with all the study object using Bipolar Prodrome Symptom Scale-Retrospective （BPSS-R） scale， to compare the recognition ability of prodromal symptoms between the patients and caregivers. Results Of the 80 patients， 73.8% （59/80） were BD-Ⅰ and 26.2% （21/80） were BD-Ⅱ， 35.0% （28/80） were female， 38.8% （31/80） of the patients had the first symptom of depression with （7.1±3.4） months' duration of the prodromal episode， 61.2% （49/80） of the patients had the first symptom of （hypo） mania with （6.1±3.6） months' duration of the prodromal episode. When the first episode of depression occurred， the recognition rates of family members for social isolation， academic and occupational dysfunction， anxiety or nervousness， trouble concentration， strange or unusual ideas were higher than that of the patients， and the severity of educational and occupational dysfunction was higher than that of the patients， and the differences were statistically significant （P＜ 0.05）. Within the first episode of （hypo） mania， the recognition rates of family members for social isolation， anxiety or nervousness， physically slowed down， insomnia， weight loss or decreasing in appetite， reduction of enjoyment or interest were higher than that of the patients， and the differences were statistically significant （P ＜ 0.05）. Regardless of whether the first episode was depression or （hypo）mania， the patients' recognition rate of depression was significantly higher than that of caregivers （P ＜ 0.01）. Conclusions There are differences in the recognition ability of bipolar prodromal symptoms between patients with BD and their families. The recognition ability of family members for prodromal symptoms in multiple dimensions other than depression is higher than that of patients.