To explore the correlation between morphological changes of cerebral peduncles and aphasia quotient (AQ) after recurrent stroke (RS) in patients with post-dominant hemisphere stroke aphasia (PSA). Methods: The clinical data of 40 patients with RS and also PSA after first-time stroke (FS) were analyzed retrospectively. According to the side of RS onset, they were divided into the ipsilateral stroke group (n= 19) and contralateral stroke group (n=21), and the demographic characteristic, difference in AQ before and after RS, and the correlation between AQ and cerebral peduncle asymmetry rate (CPAR) was analyzed. Re? sults: There was no significant difference in age; gender; course of disease, comorbidities of hypertension, hyperlipidemia, diabetes, and heart disease; unhealthy habits; stroke type; and speech recovery (P>0.05). The AQ of ischemic RS patients was higher than that of hemorrhagic RS patients (P<0.05). In the contralateral stroke group, the post-RS AQ was significantly lower than the pre-RS AQ and the ipsilateral stroke group AQ (P< 0.01). Change of AQ pre- and post-RS in the contralateral stroke group was significantly higher than that in the ipsilateral stroke group (P<0.01). There was no significant difference in CPAR between the contralateral stroke group and ipsilateral stroke group (P>0.05). There existed an apparent correlation between CPAR and the post-RS AQ of the contralateral stroke group (P<0.01) and no apparent correlation between CPAR and the pre-RS AQ of both groups and the post-RS AQ of the ipsilateral stroke group (P>0.05). Conclusion: The changes in AQ after RS in patients with PSA showed a significant association with CPAR.