We assessed the efficacy of the Chongqing Stroke Scale (CQSS) for predicting poor short-term outcome and early neurological deterioration (END) in patients with lacunar stroke. Methods: We prospectively enrolled 294 LS patients hospitalized in the Neurology Department of Aerospace Center Hospital from June 2020 to May 2021. Related baseline data were recorded and patients were evaluated by the CQSS. The main outcome events were defined as poor functional outcome at discharge [modified Rankin scale (mRS) ≥ 3 points]. The secondary outcome events were defined as END. The efficacy of the CQSS in predicting outcome events was quantified by the area under the Receiver Operating Characteristic curve (AUC). Results: The number of patients with poor prognosis and with good prognosis patients, according to the mRS scores at discharge, was 58 and 236, respectively. The initial NIHSS score, initial CQSS score, and increase of CQSS score in the poor prognosis group were higher than those in the good prognosis group, and there was a significant correlation between the initial CQSS score and NIHSS score (Pearson coefficient=0.914, P<0.001). CQSS had good predictive value for the risk of poor prognosis in LS patients at discharge (AUC=0.760, 95% CI: 0.692-0.829, P<0.001), with a cut-off value of 5 points. CQSS was less accurate in predicting END events (AUC=0.613, 95% CI: 0.538-0.689, P=0.007). Conclusion: The CQSS score has good predictive value for the risk of short-term adverse outcomes in LS patients, with a higher score indicating a greater risk of poor prognosis. Predictive value of CQSS for the risk of END is moderate, and further research is needed to improve this aspect.