Abstract: Objective: To understand the pre-hospital medical delay of middle-aged and elderly patients with acute ischemic stroke,analyze the influencing factors of pre-hospital medical delay,and provide reference for the formulation of emergency prevention and control plan for acute ischemic stroke. Methods: A total of 239 middle-aged and elderly patients with acute ischemic stroke who were treated in the outpatient and emergency treatment room were selected as the study subjects by convenience sampling method,and they were divided into delayed medical treatment group and timely medical treatment group according to whether pre-hospital medical treatment delay occurred.Binary logistic regression was used to analyze the influencing factors of pre-hospital medical delay. Results: Among the 239 patients,153 patients were in the delayed medical treatment group,and the delayed medical treatment rate was 64.02%.Multivariate logistic regression analysis showed that residence,presence or absence of consciousness disorder,hope level,disease risk perception and family care were the influencing factors of pre-hospital medical delay (OR=0.384-3.458,P<0.05). Conclusions: The incidence of delayed medical treatment of middle-aged and elderly patients with acute ischemic stroke is high.Medical staffs should pay attention to patients who live in rural areas,have no consciousness disorder at the onset,low hope level,weak disease risk perception to poor family care,to strengthen health education on disease-related knowledge,and improve the disease cognition level and medical decision-making ability of high-risk groups and their families.