Objective: Intracranial arterial stenosis (ICAS) is one of the most common causes of stroke in the world.However, knowledge of risk factors of patients with ICAS is limited, especially the ischemic stroke patents with ICAS.The aim of our study is to identify the risk factors of intracranial large-artery stenosis in acute ischemic stroke patients.Methods: 628 acute ischemic stroke patients were enrolled in our study.ICAS was assessed by using trans-cranial Doppler (TCD).Logistic regression was used to evaluate the potential risk factors associated with ICAS in patients.Short-term outcomes during hospitalization were also compared.Results: We observed that hypertension was an independent indicator for the risk of ICAS in acute ischemic stroke patients (OR=1.51, 95%CI: 1.05-2.19,P=0.026), especially in women (OR=1.21, 95%CI: 1.10-1.39, P=0.003).During hospitalization, 11 patients in the stenosis group were admitted into Neurological Intensive Care Unit (NICU),while 6 patients in the non-stenosis group were admitted into NICU (P=0.044).The occurrence rate of cerebral hernia was higher in the stenosis group(P=0.018).Conclusions: Our findings suggest that hypertension may be an independent risk factors for ICAS, especially in women acute ischemic stroke patients.In addition, ICAS patients need more NICU care and may have higher occurrence rate of cerebral hernia.Thus, more aggressive risk factor management are needed in ICAS patients.