Background <p>Cerebral infarction requires the reduction of blood lipids, but low triglycerides are associated with poor prognosis. stroke-associated pneumonia (SAP) can also lead to poor prognosis. Therefore, the purpose of this study is to investigate the correlation between triglycerides (TG) and SAP.</p> Methods <p>This prospective cohort study was conducted at the First Affiliated Hospital of Soochow University and enrolled consecutive patients with acute ischemic stroke admitted between March 2019 and March 2021. Univariate analysis, Multivariable logistic regression analysis, subgroup analysis, curve fitting, inflection point analysis, stratified and interaction analyses was performed to examine the relationship between blood TG and SAP.</p> Results <p>The study included 240 patients with acute ischemic stroke (92 females, mean age 68 years), of whom 94 developed SAP. Multivariate logistic regression analysis demonstrated that TG levels were independently associated with SAP. The fitting curve shows a linear relationship between TG level and SAP incidence, with a decrease in SAP incidence as TG increases. The inflection point value is TG = 2.6mmol/L.</p> Conclusions <p>The findings suggest that TG levels may be inversely associated with the risk of SAP in elderly patients with acute ischemic stroke.</p>