Objective: To investigate and evaluate the relativity of plasma fibrinogen and acute ischemic stroke patients’ long-term prognosis. Methods: Selected 426 samples in our hospital from May 2012 to May 2015 suffering from acute ischemic stroke as subjects of study. Recorded the baseline data such as the level of plasma fibrinogen within 24 h after patients admitted to hospital. Separated two groups based on the results of plasma fibrinogen test, which are 204 samples for hyperfibrinogenemia, and 222 samples for normal fibrinogen. By telephone following-up and outpatient service, performed the retrospective analysis and compared with the index of long-term prognosis of the two groups, assessed the prognosis effects by adopting the improved ranking (mRS), mRS ≤2 score means good long-term prognosis, mRS >2 score stands for malign long-term prognosis. Results: Compared the baseline data between hyperfibrinogenemia and normal fibrinogen, there is statistical significance on comparative differences of the two groups’ index like age, stroke severity, heart failure, recurrent cerebral infarction, type of cerebral infarction, etc. (P<0.05); the level of plasma fibrinogen >3.8 g/L is obviously correlated with mRS score (r=0.2483; P=0.0000); (3) through the multiple regression analysis, we can see that every 1 g/L rise on the plasma fibrinogen cause the death risk ratio of acute ischemic stroke patients will be 1.2836 (95% CI: 1.0604~1.5517). Conclusion: The plasma fibrinogen within 24 h after patients admitted to hospital is the independent forecast element of the long term prognosis for those acute ischemic stroke patients, which need high clinical attentions.