Introduction: Delineating predictors of dementia among ischemic stroke survivors is critical to reduce dementia burden and to improve quality of life in this population. Methods: A Metaanalysis compliant with Preferred Reporting Items for Systematic Reviews and Metaanalysis was conducted. Analysis included absolute risk, incidence rates and patient level predictors (demographics, CVD history,TIA, stroke location, disability, chronic brain changes and stroke mechanism). Additional predictors included study setting, method of dementia diagnosis and inclusion of patients with recurrent or first ever stroke. A random effects meta-analysis was undertaken. Results: 4,325 studies were screened and a total of 21 studies were included in metaanalysis, representing 55183 patients with ischemic stroke, with average age of 70 years (range 65-80 years) and average followup of 29 months. Overall rate of dementia after ischemic stroke was 13.0 per 1000 py (95% CI 6.0, 36.0). Incidence rates were eight times higher in hospital based studies (17.0, CI 8.0, 36.0) compared to registry-based studies (1.8, CI 0.8, 4.0). Absolute dementia risk after stroke was 20% at 5 year, 30 at 15 years and 48 at 25 years of follow-up. There was 33 difference in dementia incidence in the later study periods (2007-2009) compared to (1996-2006). Statistically significant predictors of dementia after ischemic stroke included female gender (OR 1.2, CI 1.1-1.4), hypertension (1.4 CI 1.1-2.0), diabetes mellitus (1.6 CI 1.3-2.1), atrial fibrillation (1.9 CI 1.2-3.0), previous stroke (2.0 CI 1.6-2.6), presence of stroke lesion in dominant hemisphere (2.4 CI 1.3-4.5), brain stem (0.5, CI 0.3-0.9) frontal lobe (3.7 CI 1.2-12.0), aphasia (7.9, CI 2.4-26.0), dysphasia (5.8 CI 3.0-11.3), gait impairment (1.7, CI 1.1-2.7), white matter hyperintensities (3.2 CI 2.0-5.3), medial temporal lobe atrophy (3.9 CI 1.9-8.3) and transient ischemic attack as the predisposing aetiology for ischemic stroke (0.44 CI 0.22-0.88). Conclusions: Factors routinely collected at time of admission are key in monitoring patients at highest risk of progression to dementia after acute ischemic stroke, in particular stroke location and presence of stroke related disability.