Objective To investigate the related factors of stroke during perioperative period undergoing fracture surgery. Methods Patients undergoing fracture surgery and suffering intraoperative or postoperative stroke from January 2013 to March 2021 in Beijing Daxing District People's Hospital, Capital Medical University were selected and set as stroke group. At the same time, those patients undergoing fracture surgery were selected in which sex and fracture site were matched at a ratio of 1∶1 and set as a control group. Data were collected through medical record system including basic information of patients, complications of chronic disease, type of fracture, operation time, type of anesthesia etc. The main outcome index was occurrence of perioperative stroke, thus Logistic regression analysis was used to analyze the risk factors of stroke in fracture patients during perioperative period. Results In this study, 140 patients were included, containing 70 patients in the stroke group and 70 patients in the control group and the incidence of stroke of perioperative operative period was 1.05%. The age and body mass index (BMI) in the stroke group were higher than those in the control group, and the operation time was longer than that in the control group, the proportion of American Society of Anesthesiologists (ASA) Ⅱ/Ⅲ in the stroke group was lower than that in the control group, and hypertension, atrial fibrillation and hyperlipidemia, the proportion of previous brain diseases was significantly higher than that in the control group (P<0.05). Age, BMI, hypertension, hyperlipidemia, atrial fibrillation, brain disease and operation time were independent risk factors for stroke in patients with fracture during perioperative period (P<0.05). The multiple regression analysis showed that independent risk factors including hypertension, hyperlipidemia, atrial fibrillation, brain disease and operation time after adjusting for confounding factors including ASA grade, gender and fracture site (P<0.05). Independent risk factors under general anesthesia were age and hypertension (P<0.05); hypertension was risk factors for stroke after adjusting confounding factors including ASA grade, gender and fracture site (P<0.05). Meanwhile, independent risk factors under combined spinal epidural with anesthesia included age, BMI, hypertension, brain disease, operation time (P<0.05). Age, brain disease and operation time were risk factors after adjusting for confounding factors containing ASA grade, gender and fracture site (P<0.05). Conclusions Hypertension, hyperlipidemia, atrial fibrillation, brain disease and operation time are the high‑risk factors of stroke in fracture patients during perioperative period. Under general anesthesia, hypertension is the high‑risk factor of stroke during perioperative period. Under spinal epidural anesthesia, age, brain disease and operation time are the high‑risk factors of stroke during perioperative period.