Objective: To study the related factors of aspirin resistance (AR) in acute ischemic stroke. Methods: A total of 138 patients with acute ischemic stroke treated in hospital affiliated to Xuzhou medical university from August 2016 to August 2018 were the study subjects, examine his medical data from the past. They were divided into the AR group (40 cases) and the non-AR group (98 cases) according to whether AR appears. Gender, disease history, biochemical indicators and etc. were compared between the two groups. The independent risk factors of AR were investigated using univariate analysis and logistic regression analysis. Results: 40 cases of AR occurred in 138 patients, with an incidence rate of 28.99%. Diabetes, platelet count (PLT), microRNA-19a (m iR-19a) expression, smoking, high-sensitivity C-reactive protein (hs-CRP), Low-density lipoprotein cholesterol (LDL-C), fibrinogen (FIB) and age difference between the AR group and non-AR group was statistically significant (P<0.05). Gender, hypertension, uric acid (UA), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), homocysteine (Hcy), total cholesterol (TC), and alanine aminotransferase (ALT) between the two groups were not significantly different (P>0.05). Logistic regression analysis showed that the independent risk factors for AR in acute ischemic stroke were diabetes (OR=2.773, 95%CI: 1.102~5.065, P=0.025), miR-19a (OR=3.021, 95%CI: 1.322~6.545, P=0.021), hs-CRP (OR=2.719, 95%CI: 1.301~5.022, P=0.028) and smoking (OR=1.983, 95%CI: 1.114~3.887, P=0.040). Conclusion: The incidence of AR is higher in acute ischemic stroke. Risk factors include diabetes, miR-19a expression, hs-CRP, smoking, etc. Clinical intervention measures can be taken to reduce the risk of AR and improve acute ischemic stroke prognosis.