This study aims to explore the epidemiological characteristics, influencing factors, and specific impacts on clinical prognosis of cardiometabolic multimorbidity (CMC) in patients with ischemic stroke. By analyzing the clinical data of 864 hospitalized patients with ischemic stroke, the study found that CMC is highly prevalent in this population, with an overall prevalence of 68.29%, among which hypertension, dyslipidemia, and diabetes mellitus are the most common types of comorbidities. Multivariable Logistic regression analysis revealed that advanced age, smoking, high salt intake, and lower socioeconomic status are key risk factors for the occurrence of CMC. Regarding the impact on prognosis, this study confirmed that the CMC status significantly increases the risk of the first stroke occurrence, which grows exponentially with the number of metabolic abnormalities. Follow-up data showed that the one-year recurrence rate in the CMC group (15.68%) was significantly higher than that in the non-CMC group (9.24%). Furthermore, patients with CMC exhibited more severe neurological deficits during the acute phase and slower recovery of long-term activities of daily living. Based on these findings, the study proposes the construction of a full-chain management system ranging from primary prevention to intensive secondary prevention, emphasizing the central role of the Multidisciplinary Team (MDT) model in improving the prognosis of patients with complex multimorbidity. This study provides important evidence-based medical grounds for optimizing clinical management pathways and public health prevention strategies for stroke patients in China.