Abstract Background The association between socioeconomic status (SES) and stroke risk remains controversial around the world. It is not clear that the effect of SES on stroke in China due to the lack of relevant research. We aimed to assess the association between SES and risks of first-ever ischemic stroke in Guangzhou, China. Methods Cases were recruited from neurology department in the First Affiliated Hospital of Guangdong Pharmaceutical University during September 2016–October 2017. Age- and sex-matched controls were derived from surgical departments, over the same period. SES was assessed based on education, occupation, and income. Education was divided into ≤6 years, 6–9 years, 10–12 years, and > 12 years. Family monthly income per capita was categorized into ≤¥1000, ¥1001–3000, ¥3001–5000, and > ¥5001. Occupation was stratified into manual, non-manual, no job, and retired. A multivariate logistic regression model was used to determine the association between SES and risk of ischemic stroke. Results In total, 347 ischemic stroke patients and 347 controls were recruited, with mean ages of 60.54 ± 13.13 and 60.56 ± 13.07 years, respectively. After adjusting for confounding factors, odds ratio (OR) for 6–9 years of education was 2.63 (95% confidence interval [CI] 1.45–4.75); > 12 years, 2.18 (1.25–3.82) compared with those for