Objective:To study the difference and clinical significance in the risk factors of acute multiple lacunar infarction(AMLI) and acute single lacunar infarction(ASLI). Methods: 62 patients with AMLI were assigned to the AMLI group, 237 patients with ASLI were assigned to the ASLI group. The risk factors were compared between the two groups. Logistic regression analysis was carried out in the differential risk factors of two groups. Results: There were more numbers of atrial fibrillation (AF) and severe stenosis of internal carotid artery (ICA) in AMLI group than that in ASLI group. Logistic regression analysis showed that AF and severe ICA had direct correlation to AMLI but had no relation to ASLI. Conclusion: AF and severe ICA are related to AMLI,suggesting that these two risk factors have significant effect on the pathogenesis of AMLI.