Objective To investigate the risk factors for progressive ischemic stroke (PIS) and the value of microemboli in predicting progressive stroke.Methods A total of 50 patients with PIS and 62 patients with non-progressive ischemic stroke (NPIS) who were admitted to Department of Neurology, Inner Mongolia People's Hospital, from March 2016 to March 2018 were enrolled. All patients underwent cranial magnetic resonance imaging, carotid artery ultrasound, echocardiography, electrocardiography, and microembolic signal monitoring within 48 hours, and a questionnaire survey was performed for all patients.Results Most of the lesions in PIS patients with microemboli were located in the cortex (P<0.05). PIS was significantly associated with microemboli, abnormal low-density lipoprotein, no administration of aspirin before admission, administration of antihypertensive drugs before admission, and carotid plaque (P<0.05). The logistic regression analysis showed that microemboli (odds ratio[OR]=7.246, P=0.001), abnormal low-density lipoprotein (OR=3.879, P=0.007), carotid plaque (OR=4.177, P=0.007), no administration of aspirin before admission (OR=4.304, P=0.046), and administration of antihypertensive drugs before admission (OR=3.734, P=0.01) were independent risk factors for PIS.Conclusions Microemboli, abnormal low-density lipoprotein, no administration of aspirin before admission, administration of antihypertensive drugs before admission, and carotid plaque are the risk factors for PIS, and microemboli have a certain predictive value.