Objective: To explore the risk factors and preventive countermeasures of perioperative cerebral infarction. Methods and results: We reviewed the clinical medical records and anesthesia process of a perioperative stroke patient and reviewed the literature. Discussion: Perioperative stroke is the result of a combination of multiple factors. Medical complications such as long history of hypertension, diabetes, history of stroke and extreme low head during laparoscopy are risk factors for stroke. Conclusion: Laparoscopic surgery should monitor high risk factors, maintain intraoperative hemodynamic stability, hidden symptoms of posterior circulation cerebral infarction, and pay early identification and timely intervention to improve the prognosis of patients.