Objective To investigate the incidence and risk factors of leukoaraiosis (LA) in hospitalized patients with acute ischemic stroke（AIS）. Methods Five hundred and ninety-three hospitalized patients with AIS were divided into the non-LA group（n=61）, mild LA group（n=324）and moderate-severe LA group（n=208） according to the severity of paraventricular LA. Five hundred and ninety-three patients were also divided into non-LA group（n=183）, mild LA group（n=257） and moderate-severe LA group（n=153） according to the severity of deep LA. The differences in clinical characteristics between the paraventricular and deep groups were compared. The risk factors for LA in the patients with AIS were analyzed by multivariate Logistic regression. Results In the enrolled cases, the incidence of paraventricular LA was 89.7% and that of deep LA was 69.1%.In the paraventricular LA group, age, blood urea nitrogen(BUN), total cholesterol(TC), low-density lipoprotein cholesterol (LDL-C）, apolipoprotein AⅠ/apolipoprotein B (apoAⅠ/apoB）, homocysteine (Hcy）, fibrinogen (Fg), hypertension (Hcy), and previous stroke history of the 3 groups were compared, and the differences were statistically significant (all P<0.05). Age, hypertension, and previous stroke history were independent risk factors for moderate-severe paraventricular LA [odds ratio(OR)=4.41, 1.94, 6.84, all P<0.05]. In the deep LA group, age, BUN, TC, apoAⅠ/apoB, Hcy, hypertension, and previous stroke history of the 3 groups were compared and showed statistically significant differences (P<0.05). Age, serum Hcy level, hypertension, and past stroke history were independent risk factors for moderate to severe deep LA (OR=3.82, OR=1.04, OR=1.96, OR=2.85, all P<0.05). Conclusions Age, hypertension, and previous stroke history are independent risk factors for moderate-severe paraventricular and deep LA in hospitalized patients with AIS. Increased serum Hcy level is an independent risk factor for moderate-severe deep LA in the patients.