Cerebrovascular diseases are the second leading cause of death in the world，often causing serious complications such as dementia，paralysis and aphasia. Ischemic cerebrovascular diseases account for about 85% of all cerebrovascular diseases. With the acceleration of the aging process in China and the large scale of the aged population，the prevention and treatment of ischemic cerebrovascular disease has become a major public health problem in China. Recent studies have found a close relationship between obesity and ischemic cerebrovascular disease，but there are still controversies，and even the theory of "obesity paradox". Obese patients usually have intestinal microflora imbalance，imbalance of lipid and hormone homeostasis，and participate in the formation of atherosclerosis through promoting platelet aggregation and thrombosis. Obese patients are in a state of chronic inflammation and oxidative stress，which leads to endothelial dysfunction. Additionally，obesity can bring about endocrine functional disorders of adipose tissue，secretion of pro-inflammatory adipokines increases，and then affect the incidence of cerebrovascular diseases. This article reviews the literatures on the correlation and mechanism between obesity and ischemic cerebrovascular diseases，in order to provide references for the prevention and treatment of ischemic cerebrovascular disease.