Objective To investigate the association between solar term of onset and syndrome type in ischemic stroke. Methods A total of 4 838 patients with ischemic stroke were selected from the system of hospitalization medical records in The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine in 2021, and the frequency distribution method was used to analyze their information such as sex, age, solar term of onset, and TCM syndrome type. The solar term of onset corresponding to the onset date was calculated, and then the association between solar term of onset and TCM syndrome type in ischemic stroke was analyzed. The circular distribution method was used to explore the peak of solar term of onset and TCM syndrome type. Results Among the 4 838 patients, there were 3 233 male patients (66.8%) and 1 605 female patients (33.2%), and the age of 60-69 years was the age group with the largest number of patients (1 814 patients accounting for 37.5%). The most common syndromes were Yin deficiency and dynamic wind syndrome in 2 268 patients (46.9%) and the syndrome of wind-phlegm blocking collaterals in 1 231 patients (25.4%). Pure Brightness was the solar term with the highest incidence rate, and there was no absolute peak for the overall solar term of onset. Waking of Insects was the peak for the onset of Yin deficiency and dynamic wind syndrome, and Lesser Fullness of Grain was the peak for the onset of the syndrome of wind-phlegm blocking collaterals. Conclusion There are more male patients than female patients with ischemic stroke, and the age group of 60-69 years has the largest number of patients. There is no absolute peak for the overall solar term of onset, while there is a peak for Yin deficiency and dynamic wind syndrome and the syndrome of wind-phlegm blocking collaterals; Waking of Insects is the peak for the onset of Yin deficiency and dynamic wind syndrome, and Lesser Fullness of Grain is the peak for the onset of the syndrome of wind-phlegm blocking collaterals, suggesting that disease onset can be observed in all 24 solar terms and active and persistent prevention is required for the key population.