The pathogenesis of stroke is complex and related to many risk factors. Leptin, as the most important molecule involved in metabolism, is closely related to diabetes, arteriosclerosis, hypertension, and other diseases. In recent years, it has been found that leptin and leptin resistance may be related to the occurrence, development, and prognosis of stroke. While some scholars have proposed that increased leptin levels can be used as an independent risk factor for stroke, a few studies have shown that leptin has neuroprotective effects. Herein, we reviewed the possible role and mechanism of leptin in stroke.