【Abstract】 Objective To explore the changes of intestinal flora and inflammation in patients with constipation after ischemic stroke. Methods From December 2016 to December 2017, 40 patients with constipation in the first ischemic stroke treated in the Department of Neurology of Chengdu western theater general hospital were included as the observation group. After age and gender matching, 40 patients without constipation in the ischemic stroke group were selected as the control group, and feces and plasma samples were collected. Results The results of qPCR showed that the abundance of Bacteroides and ruminococcea in the observation group was significantly higher than that in the control group (P＜0.05). The abundance of Prevotella in the observation group was lower than that in the control group (P＜0.05). The abundance of Escherichia coli in the observation group was higher than that in the control group (P＜0.05). The levels of TNF α and IL-1 β in the observation group were higher than those in the control group (P＜0.05). There was a significant negative correlation between the abundance of lachnospiraceae and the level of serum IL-6 in the observation group (r=-0.35, P＜0.05). There was a significant negative correlation between the abundance of ruminocacea and the level of TNF α in serum (r=-0.48, P＜0.05). The abundance of Escherichia was positively correlated with TNF-α and IL-1β (r=0.42, P＜0.05, r=0.34, P＜0.05). Conclusion The composition of intestinal flora in patients with constipation after ischemic stroke changed significantly, which was closely related to the level of inflammation in the body.