Abstract: OBJECTIVE  To establish a model for risk assessment of recurrent ischemic stroke by combining different traditional Chinese medicine (TCM) syndromes with oculus fundus vascular characteristics.METHODS  In a prospective observational study, a total of 425 ischemic stroke patients who met the inclusion criteria were enrolled and followed up for two years. In addition, the information on clinical risk factors, TCM syndromes, and oculus fundus vascular characteristics related to stroke were collected. Survival analysis was used to compare the risk of recurrence in patients with ischemic stroke with qi deficiency and blood stasis and wind-phlegm obstructing collaterals. A multifactorial Logistic risk assessment model was developed for each of the two evidence types using single-factor analysis to identify the core risk factors for stroke recurrence and oculus fundus vascular characteristics.RESULTS  Through comparing the recurrence risk between the two syndromes, we found that the recurrence risk was higher in the wind-phlegm obstructing collaterals syndrome than that in the qi deficiency and blood stasis syndrome (P < 0.05). The area under curve value of the ischemic stroke risk assessment model of qi deficiency and blood stasis syndrome was 0.799 6, while the value of the ischemic stroke risk assessment model of wind-phlegm obstructing collaterals syndrome was 0.719 3.CONCLUSION  The risk of recurrence in patients with ischemic stroke of wind-phlegm obstructing collaterals syndrome is higher than that of qi deficiency and blood stasis syndrome, and the establishment of a risk factor model to identify recurrence in different syndromes of ischemic stroke can provide targeted prevention strategies for clinical practice.