To assess the predictive value of high sensitivity C reactive protein (Hs-CRP) level and ABCD2 score in the short-term prognosis of patients with transient ischemic attack (TIA). Methods: Two hundred and twenty-six patients with TIA were involved in the study. Patients were divided based on the progression to acute cerebral infarction within 7 days of TIA into the ACI group (n=27) and non-ACI group (n= 199). Common cerebrovascular disease risk factors, Hs-CRP level, and ABCD2 score were recorded. Single factor and multi-factor analyses were used to assess the difference in risk factors of cerebrovascular disease, Hs-CRP level, ABCD2 score between the ACI group and non-ACI group. Receiver operating characteristic (ROC) curve analysis was used to investigate the value of ABCD2 score combined with Hs-CRP level in predicting the occurrence of ACI within 7 days of TIA. Results：Of the 226 patients, 27 developed ACI, yielding a 11.95% poor prognosis rate. Univariate analysis showed that there was a significant difference between the non-ACI group and ACI group in hypertension, diabetes, age >65 years, attack duration ≥30 min, attack frequency ≥3 times, course of disease ≥24 h, Hs-CRP level, and ABCD2 score (all P<0.05). Multi-factor logistic analyses showed that hypertension, diabetes, age >65 years, attack duration ≥30 min, attack frequency ≥3 times, course of disease ≥24 h, ABCD2 score, and Hs-CRP level were also independent risk factors for the development of ACI after TIA. ROC curve analysis revealed that in predicting ACI, the ABCD2 score and Hs-CRP level showed an area under the curve (AUC) of 0.848 and 0.824, respectively. Conclusion: ABCD2 score is a simple and effective tool in predicting TIA prognosis, and Hs-CRP level combined with ABCD2 score offers significant predictive value in determining TIA prognosis.