With an increasing incidence rate, ischemic stroke has become a major public health problem. Early and effective secondary prevention is a key strategy for reducing its high morbidity, high recurrence and high mortality. Combined with the clinical phenotypes and imaging features, the application of potential blood biomarkers can provide the scientific basis for early screening and treatment monitoring to assess stroke recurrence risk stratification, then guide individualized secondary prevention. This article describes and analyzes the current clinical application, existing challenge, and the future development model of blood biomarkers in the field of secondary stroke prevention.近些年,缺血性脑卒中的发病率逐年增高,已成为重大公共卫生问题。早期有效的二级预防是减少其高发病率、高复发率和高致死率的关键手段。结合传统的临床表型和影像学特征的诊断模式,一些潜在血液生物标志物的应用可为缺血性脑卒中复发风险的早期筛查和治疗监测提供有价值的科学依据,以综合评估脑卒中再发风险分层,从而指导个体化的脑卒中二级精准预防。本文阐述了血液生物标志物在缺血性脑卒中二级预防中的临床应用、面临的挑战以及未来发展模式。.