To investigate the correlation between cervical vessels tortuosity and the age of first onset in cerebral ischemia events. Methods: Clinical data of 168 inpatients was retrospectively analyzed. Of these, 135 patients with first onset of ischemic stroke (AIS) and transient ischemic attack (TIA) were included in the cerebral ischemic events group. The remaining 33 patients with no cerebral ischemic events were included in the control group. All patients underwent digital subtraction angiography (DSA) on cerebral vessels. The tortuosity index (TI) of the C1 segment of the internal carotid artery (ICA) and V1 segment of the vertebral artery (VA) was measured respectively. The Spearman rank correlation coefficient was used to analyze the relationship between cervical vessels tortuosity index and age of first onset of cerebral ischemic events. Results: In the cerebral ischemic events group, the TI of the C1 segment of the right ICA (rs=0.301， P<0.001), C1 of left ICA (rs=0.299，P<0.001), V1 of right VA (rs=0.382，P<0.001), and V1 of left VA (rs= 0.374，P<0.001) were positively correlated with age at first onset and negatively correlated with the male gender. In the control group, only the TI of the right VA V1 segment was positively correlated with age (rs= 0.415, P=0.016), and there was no significant correlation between cervical vessels TI and gender. Conclusion: Increased cervical vessels tortuosity is associated with an increased age at first onset of cerebral ischemic events, and this is more prominent in female patients. Cervical vessels tortuosity does not lead to an earlier age of first onset of cerebral ischemic events.