Introduction: There are few reports about the association of concentrations and proportions of serum fatty acids with age at the onset of acute ischemic stroke (AIS) in elderly patients. Hypothesis: A higher level of saturated FA (SFA) and n-6 polyunsaturated FA (PUFA) cause a younger onset of AIS, and a higher level of n-3 PUFA causes an older onset of AIS. Methods: For the retrospective cross-sectional study, we included patients aged 50 years or older who: 1) were admitted to our institution between August 2016 and July 2019 within 24 hours of AIS onset, and 2) underwent an examination of serum fatty acids. We evaluated concentrations of palmitic acid (PA) and stearic acid (SA) as SFA, oleic acid (OlA) as n-9 PUFA, linoleic acid (LiA), dihomo-gamma-linolenic acid (DGLA), arachidonic acid (AA) as n-6 PUFA on admission. We evaluated the concentration of alpha-linolenic acid (AlA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) as n-3 PUFA on admission. We evaluated the proportion of PA, SA, OlA, LiA, DGLA, AA, AlA, EPA, and DHA on admission. Furthermore, we evaluated their correlations with age at the AIS onset. Results: Three hundred sixty-six patients met our inclusion criteria. Their median average age was 75 years. Age at the onset was negatively correlated with concentrations of PA, SA, OlA, LiA, DGLA, AA, and AlA. Age at the onset was negatively correlated with the proportion of SA, OlA, and DGLA and positively correlated with the proportion of EPA and DHA. Multiple regression analysis showed that DGLA was an independent factor for the younger onset of AIS. Multiple regression analysis showed that DHA proportion was an independent factor for the older onset and that proportions of SA and DGLA were independent factors for the younger onset of AIS. Conclusions: The higher proportion of SA (SFA) and higher concentration and proportion of DGLA (n-6 PUFA) were significantly correlated with the younger onset of AIS, and the higher proportion of DHA (n-3 PUFA) was significantly correlated with the older onset of AIS.