Objective To study and discuss the correlation between enlarged perivascular space （EPVS） and the severity of cerebral edema （CED） in patients with acute ischemic cerebral infarction. Methods The clinical data of patients with acute cerebral infarction who visited the Affiliated Hospital of Xuzhou Medical University within 24 hours after onset from August 2015 to October 2020 were retrospectively investigated. The degree of CED and EPVS grade of stroke were evaluated by cranial imaging data after admission. The patients were divided into two groups with or without CED， and the correlation between EPVS and cerebral edema was studied. The degree of cerebral edema was further divided into three groups： CED1， 2 and 3. EPVS was divided into three groups： mild， moderate and severe. The factors affecting the severity of CED and the relationship between them were analyzed. Results A total of 342 patients with acute cerebral infarction were included， 216 male patients and 126 female patients， with an average age of （66.47±12.10） years. The proportion of atrial fibrillation， National Institutes of Health Stroke Scale （NIHSS） score， white matter hyperintensity， and EPVS in the group with edema were significantly higher than those in the group without edema， and the differences were statistically significant （P＜ 0.05）. Multivariate logistic regression analysis indicated that NIHSS score and moderate to severe EPVS were positively correlated with the occurrence of edema （β=0.067， P=0.013； β=0.916， P=0.003）， that is， the risk of edema was increased （OR=1.069，2.500）， which was an independent risk factor. The results of univariate and multivariate logistics regression analysis grouped according to different degrees of edema in patients showed that the degree of EPVS was an independent risk factor leading to moderate and severe edema （P＜ 0.05）. EPVS was positively correlated with edema， and the risk of edema increased with the severity of EPVS （CED1 OR=4.692， P=0.015； OR=5.100， P=0.026； CED2 OR=9.432， P=0.008； OR=13.099， P=0.009）. Conclusions EPVS is an independent risk factor for cerebral edema， and EPVS may be an imaging predictive marker of cerebral edema in patients with acute cerebral infarction.