To explore the relationship between atherosclerotic cerebral infarction and polymorphism of the phosphoenolpyruvate carboxykinase gene (PCK1) promoter-232 in the Hainan population. Meth? ods: We recruited 160 patients with atherosclerotic cerebral infarction as the observation group and another 160 healthy adults who received check-ups during the same time as the control group. PCK1 promoter-232 gene polymorphism was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP); the carotid intima-media thickness and carotid artery plaque (CAP) were detected by carotid doppler ultrasonography. The blood glucose and plasma lipids were measured. Results: The 2 h postprandial blood glucose and LDL cholesterol levels of the GC and GG genotypes in the observation group were higher than those of the CC genotype (F=12.811, 54.169, both P<0.001). Compared with that of the control group, the frequencies of GC and GG genotypes and the G allele in the observation group were significantly higher ( χ 2 =13.341, 10.807, all P= 0.001). With vulnerable plaques, the distribution of GC and GG genotypes and the G allele in the observation group were significantly larger than that with non-vulnerable plaques (χ 2 =5.186, 7.276, P=0.023, 0.007). The carotid intima-media thickness of the left and right carotid artery of different genotypes in the two groups were compared and showed no statistical difference (F=0.742, 0.485, 1.139, 0.727, P=0.478, 0.617, 0.325, 0.487). Conclusion: There is a certain connection between PCK1 promoter-232 gene polymorphism and the occurrence of atherosclerotic cerebral infarction in the population of Hainan, and the role of G allele is more prominent