Ischemic stroke (IS) is one of the main causes inducing death and disability in adults. Because of the high recurrence rate of IS, prevention of recurrence is of great significance to this population, for which the evidence-based and effective secondary prevention strategy is an important means, and acupuncture intervention has a positive effect on its risk factors. In the present article, we reviewed the progress of researches on the mechanisms of acupuncture underlying prevention of IS relapse from the perspective of its main risk factors, namely 1) hypertension (preventing and controlling the adverse effects caused by the imbalance of blood pressure level, vascular and other tissue structures, endocrine factors and central nervous system activities in patients with hypertension after IS), 2) hypercholesterolemia (lowering serum total cholesterol, triglyceride, low-density lipoprotein-cholesterol (LDL-C) and raising high-density lipoprotein cholesterol), 3) diabetes (regulating the secretion function of adipose tissue, activating the insulin signal transduction pathway, protecting the function of pancreatic β cells, and regulating the central nervous system functions to participate in the secondary prevention of IS), 4) smoking (relieving the symptoms of smoking cessation and reducing the smoker's dependence on smoking by changing the internal environment, lowering the level of blood endorphin and regulating the excitability of central nervous system), 5) sleep apnea syndrome (regulating local muscle function and the excitability of the nervous system, but also affecting some organic changes as reducing tonsil swelling) and 6) obesity (lowering blood glucose and lipid, increasing the ratio of brown/white fat, reducing leptin resistance, and suppressing appetite to induce body weight loss, or directly regulate the changes of fat tissue, etc). Results shows that the acupuncture's regulatory mechanism for IS risk factors is closely related to the neuroendocrine system, and simultaneously involves multiple targets of multiple risk factors. Due to its good efficacy and safety, acupuncture therapy is of great value for clinical promotion as an important intervention for secondary prevention. 由于缺血性脑卒中（IS）复发率高，预防IS复发具有重要意义，循证而有效的二级预防策略是当前干预IS的重要手段，针刺对IS二级预防相关危险因素均具有积极作用。本文从针刺对IS二级预防主要危险因素，即高血压（控制IS后血压水平，预防血管等组织结构、内分泌因子及中枢神经系统等不同维度失调后造成的不良影响）、高胆固醇血症（降低血清总胆固醇、甘油三酯和低密度脂蛋白胆固醇含量，提高高密度脂蛋白胆固醇含量）、糖尿病（调节脂肪组织分泌功能，激活胰岛素信号转导通路，保护胰腺β细胞功能，调节中枢神经系统功能）、吸烟（降低血液内啡肽水平，调节中枢神经系统兴奋性，缓解戒烟症状，减少吸烟者对吸烟的依赖）、睡眠呼吸暂停综合征（调节局部肌肉功能和神经系统兴奋性，减轻扁桃体肿胀）、肥胖（降低血糖和血脂，增加褐色/白色脂肪比例，减轻瘦素抵抗，抑制食欲，调节脂肪组织的存在形式）6大方面的作用机制角度，对当前相关研究进展进行综述。结果显示，针刺对于IS危险因素的调节机制多与神经-内分泌系统密切相关，且可同时兼顾多种危险因素的多个靶点。针刺疗法作为一种重要的二级预防干预手段，具有良好的疗效、安全性及重要的临床推广价值。.