Objective To analyze the prognostic factors in >40-year-old patients with cerebral apoplexy in the urban area of Changde, Hunan Province, China. Methods An epidemiological investigation of stroke was conduct by trained professionals using the unified questionnaire, which involved 6095 individuals over 40 years old in the central city of Changde. Patients with cerebral apoplexy were divided into good prognosis and poor prognosis groups after assessment with the modified Rankin scale. Univariate analysis was performed using the χ²/t test and multivariate analysis was performed using logistic regression. Results A total of 628 patients with cerebral apoplexy were found in the community survey. There were 332 cases (52.87%) in the good prognosis group and 296 cases (47.13%) in the poor prognosis group. Univariate analysis showed that the two groups of patients had significant differences in terms of age, educational level, history of stroke, history of smoking, blood glucose level, type of stroke, type (lesion site or hematoma size) of cerebral hemorrhage, and subtype of ischemic stroke (P<0.05). Multivariate analysis showed that poor prognosis was related to advanced age, low educational level, and history of stroke (P<0.05).Conclusions Age, educational level, history of stroke, and type of stroke are major poor prognostic factors in patients with cerebral apoplexy. Effective measures should be taken to improve the prognosis of stroke patients.