Ischemic stroke is a type of cerebrovascular disease with a high disability rate. Recent studies have found that ischemic stroke breaks the stability of the intestinal ecological environment, resulting in alterations in the composition of gut microbiota and related derivatives. These changes lead to the exacerbation of local immune inflammatory responses and the increase of infarct volume after stroke, which is a potential risk factor for stroke prognosis. This review aims to summarize the inflammatory response process, changes in gut microbiota and related derivatives, as well as the immune inflammatory reactions mediated by gut microbiota during cerebral infarction.