Objective To explore the level of psychosocial adjustment of ischemic stroke patients and to identify its influencing factors. Methods A questionnaire survey was conducted on 291 ischemic stroke patients. The instruments included the Psychosocial Adjustment to Illness Scale Self-report, Family APGAR Index, Hospital Anxiety and Depression Scale and the Barthel Index. Results The total score of psychosocial adjustment to illness in ischemic stroke was (57.59±13.82). The number of complications, sleep quality, family function, anxiety and depression were predictors of psychosocial adjustment to illness (P<0.01 for all). Conclusion Psychosocial adjustment to illness among ischemic stroke patients needs to be enhanced. Those with poor sleep quality, experiencing anxiety and depression, with poor family function, and having more complications, should be paid more attention.