Objective?To study the correlation between serum albumin（Alb）level and death risk of ischemic stroke（IS）patients after discharge.Methods?A total of 2 207 patients who were first diagnosed as IS and discharged from Yixing Hospital affiliated to Jiangsu University from April 2009 to December 2017 were continuously included.The general demographic data and results of biochemical tests of the respondents were collected，and centralized follow-up was conducted from December 2018 to April 2019.Those who lost follow-up and Alb information were excluded.Finally，a total of 1 976 patients were included for analysis in the study.According to the restricted cubic spline curve，an appropriate cut-off value was selected to group the patients.The high Alb group consisted of 991 patients with Alb＞41 g／L，and low Alb group consisted of 985 patients with Alb≤41 g／L .COX proportional hazard regression model was used to analyze the hazard ratio（HR）of Alb expression level to the death of IS patients after discharge.Results?Among the 1 976 subjects with 4.72 years of median follow-up time，102 cases died of ischemic stroke during 6 months after discharge.Following multivariate COX regression analysis to correct gender，age，smoking，drinking，blood lipid，history of hypertension and diabetes，the low Alb group had a 1.618-fold increased risk of death compared with the high Alb group（HR＝1.618，95%CI：1.060-2.469）.The results of further stratified analysis showed that among the male subjects over 65 years of age with history of hypertension，the risk of death in the low Alb group was significantly higher than that in the high Alb group.In TOAST classification，the risk of death in low Alb group was increased compared to high Alb group with the type of large-artery atherosclerosis（LAA）showing statistically significant difference.Conclusion?Low level of Alb may increase the death risk of IS patients after discharge.