Objective: To detect the changes of serum uric acid in patients with anterior and post circulation acute ischemic stroke (AIS), and to explore its prognosis significance. Methods: The clinical data of 141 patients with AIS were analyzed retrospectively. They were divided into the anterior circulation group and the posterior circulation group according to the injury site. The levels of serum uric acid, Barthel index (BI), and neurological deficit (NIS) were measured, and the correlation between serum uric acid level and BI index or NIS score was analyzed by Pearson correlation analysis. The patients were divided into good prognosis group and bad prognosis group according to their prognosis. Risk factors for poor prognosis in patients with anterior and posterior circulation AIS were determined by multivariate logistic regression analysis. Results: According to Pearson correlation analysis, there was a significant negative correlation between serum uric acid level and BI index in the anterior and posterior circulation groups (r=-0.832, -0.801, P=0.002, 0.005), while there was a significant positive correlation between serum uric acid level and NIS score in the anterior and posterior circulation groups (r=0.874, 0.885, P=0.000, 0.000). There were no significant differences in the proportion of sex, smoking history, past transient ischemic attack history, hypertension, coronary heart disease, hyperlipidemia, atrial fibrillation, diffuse intravascular coagulation branch number and the proportion of patients receiving cranial valve decompression between the good and bad prognosis groups (P>0.05), while the proportion of age over or equal to 60 years old, duration from onset to thrombolysis more than 4.5 hours, admission hyperuricemia, BI index below 60 points, NIS score higher than 12 points,were higher than those with good prognosis (P<0.05). Logistic regression analysis showed that age over or equal to 60 years old, duration from onset to thrombolysis more than 4.5 hours, admission hyperuricemia, BI index below 60 points, NIS score higher than 12 points, were independent risk factors for poor prognosis in patients with anterior and posterior circulation AIS (P<0.05). Conclusion: The levels of serum uric acid in patients with anterior and post circulation AIS are closely related to the patient′s self-care ability and neurological deficit, and it can be used as reference indexes for prognosis.