Abstract: Objective To investigate the association between alcohol drinking and all-cause death in patients with ischemic stroke. Methods Between January, 2010 and July, 2018, consecutive patients with first-episode ischemic stroke admitted in the West China Hospital, Sichuan University were enrolled, and all the patients were followed up every 3 months. Chi-square test was used to compare the differences in the baseline characteristics between the pre-stroke drinkers and the nondrinkers. The Cox regression model was used to analyze the effects of drinking status, drinking years, drinking frequency, average single alcohol intake before stroke and drinking status during the follow-up period on the mortality of patients after discharge. Results A total of 855 patients with ischemic stroke were enrolled, and deaths occurred in 140 of these patients. Chi-square test showed significant differences in gender (P<0.001), weekly physical exercise time (P=0.035), smoking (P<0.001), and heart disease (P<0.001) between the pre-stroke drinkers and nondrinkers. Multivariate Cox regression analysis showed that drinking during the follow-up period (P=0.001), drinking for less than 28 years before stroke (P=0.035) and a moderate drinking frequency (5 to 20 times per month for males and 4 to 9 times per month for females; P=0.030) were associated with a lowered risk of death after discharge. No significant effects of pre-stroke drinking status or average single alcohol intake were found on death after ischemic stroke. Conclusions The drinking years and drinking frequency before stroke and drinking status during the follow-up period are related to the all-cause mortality in patients with ischemic stroke. Investigations of the more specific variables of drinking behaviors during the follow-up period are needed to further clarify the association between drinking and death after ischemic stroke.