Introduction: In China, ischemic stroke has a high recurrence rate, with recurrent events often resulting in greater disability and mortality than initial strokes. This study aimed to evaluate the current knowledge, attitudes, and practices (KAP) of family members of patients with cerebral infarction regarding stroke recurrence and secondary prevention. Methods: A cross-sectional study was conducted from March 2024 to July 2024 in hospitals across Heilongjiang Province. Structured questionnaires were used to collect demographic data and assess KAP scores among family members of patients with cerebral infarction. Results: A total of 561 valid questionnaires were collected. The median scores (25th, 75th percentiles) for KAP were 8 (7, 10) out of 11, 37 (35, 39) out of 45, and 32 (30, 35) out of 40, respectively. Multivariate logistic regression analysis showed that practice scores were independently associated with the following factors: attitude score (OR = 1.218, 95% CI: [1.134, 1.309], p < 0.001), being a farmer (OR = 0.145, 95% CI: [0.033, 0.648], p = 0.011), being retired (OR = 0.097, 95% CI: [0.018, 0.521], p = 0.007), being unemployed (OR = 0.123, 95% CI: [0.027, 0.559], p = 0.007), patient diagnosed with hypertension for less than 1 year (OR = 2.526, 95% CI: [1.157, 5.514], p = 0.020), frequent smoking (OR = 0.436, 95% CI: [0.269, 0.709], p = 0.001), patient occasionally forgetting medication (OR = 0.434, 95% CI: [0.216, 0.874], p = 0.019), patient frequently forgetting or stopping medication (OR = 0.255, 95% CI: [0.108, 0.602], p = 0.002), patient diagnosed with cerebral infarction 2–3 times (OR = 0.497, 95% CI: [0.315, 0.786], p = 0.003), holding a college diploma (OR = 6.634, 95% CI: [1.128, 39.010], p = 0.036), holding a bachelor’s degree (OR = 6.434, 95% CI: [1.113, 37.182], p = 0.038), and not living with the patient (OR = 0.326, 95% CI: [0.180, 0.593], p < 0.001). Conclusion: Family members of patients with cerebral infarction demonstrated moderate knowledge, positive attitudes, and proactive practices regarding stroke recurrence and secondary prevention.

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