To investigate the etiology classification features and related risk factors of ischemic stroke in young women. Methods: We retrospectively analyzed the clinical data of 67 young female ischemic stroke patients (young stroke group) as well as that of 67 randomly selected elderly female ischemic stroke patients (elderly stroke group) and 67 young female healthy controls (young control group) who underwent routine examination during the same time period. The clinical data of all subjects were analyzed to identify the etiology classification features and related risk factors. Results: (1) According to the Chinese Ischemic Stroke Subclassification (CISS) system, the young stroke group was largely comprised of large artery atherosclerotic (LAA) stroke (32.84%) and cardiogenic stroke (25.37%). (2) The incidence of hypertension, diabetes mellitus, hyperlipemia, and atherosclerotic plaque were lower in the young stroke group compared to those in the elderly stroke group (all P<0.05), but the proportion of patients with a family history of stroke was higher in the young stroke group than that of the old stroke group (P<0.05). Compared with the young healthy controls, the young stroke patients displayed a higher incidence of hypertension, diabetes mellitus, hyperlipemia, hyperhomocysteinemia, smoking, cardiac disease, oral contraceptives, migraine with aura, and family history of stroke (P<0.05). (3) The results of multivariate Logistic regression analysis showed that hypertension, diabetes, hyperlipidemia, hyperhomocysteine, and smoking are independent risk factors for stroke in young women. Conclusion: Ischemic stroke etiology classification characteristics and related risk factors in young female patients were different from those in elderly female patients. Early etiological classification and detection of risk factors are beneficial for the prevention and treatment of ischemic stroke in young women.