To explore the correlation between infarction site and Chinese medicine syndromes in acute cerebral infarction (ACI).Methods:Eighty-nine selected ACI patients were prospectively studied to identify acute infarction site by diffusion weighted imaging (DWI) plus neurological deficit sign. The location of infarction was classified according to the cerebral circulation system, i.e. the anterior infarction, including those occurring in cortex, white matter or basal ganglia, and the posterior infarction including those in brain stem, thalamus or cerebella. The TCM syndrome differentiation was performed within 30 days after attack to classify as predominant excess syndrome, predominant deficiency syndrome, and syndrome with same degree of excess & deficiency.Results:Most cortical infarction incidences were of excess syndrome (58.8%), while only 17.6% was found as deficient. The result was reversed in basal ganglia infarction with 85.7% of deficiency syndrome yet zero excess syndrome. In white matter infarction 42.9% was of excess syndrome compared with a 35.7% deficiency syndrome. Posterior circulation infarction had more excess syndrome (46.7%) than deficiency syndrome (20.0%). Conclusions:The correlation between site of infarction and Chinese medicine syndromes in ACI is that single cortical or brainstem infarction are mostly seen in predominant excess syndrome, single basal ganglia infarction are in predominant deficiency syndrome.