Post-stroke gastrointestinal dysfunction is a consequence of an imbalance in the braingut axis involving autonomic dysfunction, amplified neuroinflammation, impaired intestinal barrier, and abnormal metabolism of flora. Abnormal bidirectional regulation between the central nervous system and the gastrointestinal tract allows gastrointestinal dysfunction and post-stroke neurologic damage to reinforce each other in a continuous pathological cycle. Recent studies targeting the brain-gut axis have revealed the potential roles of autonomic regulation, immune-inflammatory modulation and intestinal microecological repair in gastrointestinal dysfunction, providing new ideas for optimizing intervention strategies. Future research should further focus on the dynamic regulation mechanism of the brain-gut axis and explore the synergistic effects of multidimensional interventions, with the aim of providing precise theoretical support and therapeutic direction for the improvement of the brain-gut axis and the recovery of post-stroke neurological function.