【Abstract】Objective To explore the related influencing factors of rehabilitation training compliance in elderly patients with hemiplegia after acute stroke. Methods Clinical data of 149 elderly patients with acute post-stroke hemiplegia admitted to our hospital from April 2021 to April 2023 were collected and retrospectively analyzed. Rehabilitation exercise compliance scale was used to evaluate their compliance, and the scores of physical exercise compliance, exercise monitoring compliance and proactively seeking advices on compliance were compared among the patients with different clinical characteristics. SPSS statistics 22.0 was employed for data analysis. Depending on the data type, student′s t test or ANOVA was applied for inter-group comparison. Multivariate logistic regression analysis was conducted to analyze the influencing factors of the compliance in these elderly patients. Results For the 149 elderly patients with acute post-stroke hemiplegia, the score of physical exercise compliance, exercise monitoring compliance and proactively seeking advice on compliance was (20.19±5.15), (7.21±2.88), and (7.42±2.64) points, respectively. Significant difference was observed in the physical exercise compliance score among the patients with different education level, marital status, family monthly income, severity of neurological deficit and anxiety or depression (P<0.05), so was in the score of exercise monitorin compliance among the patients with different education levels and anxiety or depression (P<0.05), and in the score to proactively seeking advice on compliance in the patients with different education level, marital status and being anxious or depressed (P<0.05). Multivariate logistic regression analysis showed that education level at junior high school (OR=2.469,95%CI 1.244-4.900), divorced or widowed or unmarried (OR=3.109,95%CI 1.437-6.726), monthly family income <2 000 yuan/month (OR=2.436,95%CI 1.228-4.832), anxiety or depression (OR=1.346,95%CI 1.038-1.745), and severe neurological deficit (OR=3.775,95%CI 1.841-7.741) were the risk factors for compliance to physical exercise. Education level of junior high school (OR=1.190,95%CI 1.006-1.408) and anxiety or depression (OR=1.438,95%CI 1.118-1.850) were the risk factors for patients′ compliance to exercise monitoring. Education level of junior high school (OR=3.987, 95%CI 1.419-11.202), divorce or widowed or unmarried (OR=3.883,95%CI 1.502-10.038), and anxiety or depression (OR=1.927,95%CI 1.333-2.786) were risk factor for compliance to proactively seeking advice. Conclusion The rehabilitation training compliance in elderly patients with acute post-stroke hemiplegia is affected by many factors, such as education level, marital status, family monthly income, anxiety or depression, and severity of neurological deficit, and all of these factors should be paid attention to by clinicians.