Objective To explore the value of Thromboela-stography(TEG) and traditional predictors in predicting stroke thromboembolism. Methods Using a single center retrospective cross-sectional study method, 178 stroke patients who met the criteria for TEG testing in the blood transfusion department of our hospital from October 2019 to March 2022 were consecutively included as the study objects. After admission, TEG and blood sampling were performed for traditional indicators. According to the imaging diagnosis results, they were divided into simple stroke group (n=97) and venous thromboembolism (VTE) group (n=81). The patients with VTE were divided into good prognosis group (n=59 cases) and poor prognosis group (n=22) according to the modified Rankin Scale (mRS). TEG analyzer was used to detect the changes of TEG related indexes (coagulation reaction time (R), blood clot formation time (K), maximum amplitude (MA) and coagulation index (CI)). The level of traditional coagulation indexes ((fibrinogen, FIB), activated partial thromboplastin time (APTT), thrombin time (TT), and prothrombin time (PT)) were measured by automatic coagulation analyzer. Pearson was used to analyze the relationship between traditional coagulation indexes and TEG indexes; ROC curve was used to analyze the predictive value of traditional coagulation index and TEG index for stroke with VTE. Results The R and K values in patients with VTE were significantly lower than those in patients with simple stroke, and the MA, CI values and Angle angle were significantly higher than those in patients with simple stroke (P<0.01). The level of FIB in patients with VTE was significantly higher than that in patients with simple stroke, and the levels of APTT, TT and PT were significantly lower than those in patients with simple stroke (P<0.01). The level of FIB was negatively correlated with R and K, and positively correlated with MA, CI and Angle angle (P<0.05). APTT was positively correlated with R and K values, MA, CI values, and Angle angle (P<0.05), TT was positively correlated with R and K values, and negatively correlated with MA, CI values, and Angle angle (P<0.05). PT was positively correlated with R and K values, and negatively correlated with CI values and Angle angle (P<0.05). The area under the curve for predicting stroke with VTE by combined detection of TEG indicators was 0.927, and the area under the curve for combined detection of traditional coagulation indicators was 0.906. The area under the curve to predict the prognosis of stroke patients with VTE by combined detection of TEG indicators was 0.889, and the area under the curve by combined detection of traditional coagulation indicators was 0.861. TEG had a slightly higher predictive value for the prognosis of stroke patients with VTE. Conclusion The traditional coagulation index and TEG index have a certain value in predicting thromboembolism in stroke patients. They can timely identify the abnormal coagulation status of stroke patients and evaluate the prognosis of patients. However, TEG has a slight advantage and clinical needs to be combined, which is conducive to early prediction of disease outcomes