Objective To analyze the recurrence influencing factors of acute ischemic stroke based on propensity score matching. Methods A total of 913 patients with first diagnosis as acute ischemic stroke who were discharged from Shanxi Cardiovascular Hospital from January to July 2021 were selected as the research subjects. The patients were divided into recurrent group （n=276） and non-recurrent group （n=637） based on the presence of new infarcts. The general data of the two groups were compared before matching. The propensity score matching method was used to match the general data with statistically significant differences between the two groups， with a ratio of 1∶1 and 1∶2， and a caliper value of 0.02. After 1st matching， both the recurrent and non-recurrent groups consist of 273 patients. 265 patients were included in the recurrent group and 528 patients were included in the non-recurrent group in the 2nd match.Multivariate Logistic regression model was used to analyze the influencing factors of recurrence in patients with acute ischemic stroke. Results There was a statistically significant difference in age， gender， smoking， and alcohol consumption between the recurrent group and non-recurrent group before matching （P ＜ 0.05）. After twice matches， there was no statistically significant difference in age， gender， smoking， and alcohol consumption between the two groups of patients （P ＞ 0.05）. The 1st multivariate stepwise Logistic regression analysis showed that hypertension （OR=1.868， 95%CI=1.251-2.790）， diabetes （OR=1.589， 95%CI=1.063-2.375）， systolic pressure（OR=0.983，95%CI=0.972-0.994）， low-density lipoprotein （OR=0.793， 95%CI=0.639-0.983）， homocysteine （OR=0.984， 95%CI=0.970-0.997）， D-dimer （OR=2.537， 95%CI=1.477- 4.357） were recurrence influencing factors in patients with acute ischemic stroke. After the 2nd matching， multivariate stepwise Logistic regression analysis showed that hypertension （OR=1.904， 95%CI=1.344-2.698）， diabetes （OR=1.637， 95%CI=1.157-2.315）， triglycerides （OR=0.800， 95%CI=0.644-0.995）， low-density lipoprotein （OR=0.776， 95%CI=0.629-0.958）， homocysteine （OR=0.987， 95%CI=0.975-1.000）， and D-dimer （OR=1.515， 95%CI=1.160-1.977） were influencing factors for recurrence in patients with acute ischemic stroke （P ＜ 0.05）. Conclusions The recurrence influencing factors of acute ischemic stroke include hypertension， diabetes mellitus， low density lipoprotein， homocysteine， and D-dimer.