Background and Purpose: The Cincinnati Pre-hospital Stroke Severity Scale (CPSSS) is a brief 3-item assessment tool to predict stroke severity and large vessel occlusion (LVO)designed for pre-hospital and emergency department use.We validated the clinical utility of CPSSS in identifying acute ischemic stroke (AIS) patients with LVO in Chinese population.Methods: All AIS patients from January 1, 2013 to December 31, 2014 were retrospectively reviewed.We enrolled those patients with symptom onset less than 24 hours and digital subtraction angiography record were enrolled in our study.The score of CPSSS was evaluated according to the National Institutes of Health Stroke Scale (NIHSS) from admission record information.Receiver operating curves, area under the curve, and likelihood ratios were used to evaluate the predictive value for LVO.Results: One hundred and forty patients were enrolled (75.7% male, mean age 64 years) in our study.Of them, the median NIHSS score was 4, range from 0 to 39.Large vessel occlusion confirmed by DSA was present in 42 (30%) of 140 patients.Receiver operating curves showed an acceptable capacity to predict LVO of the CPSSS scale (area under the curve 0.699).A CPSSS score≥1 had sensitive 61.9% and specific 72.5%,positive likelihood ratio 2.25, negative likelihood ratio 0.53 for detecting LVO.Conclusions: The CPSSS scale is a simple tool that may be useful to identify patients with acute ischemic stroke with LVO in the pre-hospital setting in Chinese acute ischemic stroke population.