Objective To systematically review the epidemic trend and disease burden of ischemic stroke in the Chinese population and to provide references for formulating reasonable prevention and treatment measures and allocating health resources. Methods Based on Global Burden of Disease (GBD) data, we analyzed the morbidity, mortality, disability-adjusted life year (DALY) and normalized rates for ischemic stroke in China from 1990 to 2019 and evaluated the changes in the disease burden by sex and age group. Meanwhile, joinpoint regression model was constructed to analyze the time trend change in each stage during the study period. Results Compared with 1990, the incidence, mortality and DALY rate of ischemic stroke in China increased by 171.68%, 125.60% and 98.60% in 2019, among which the incidence, mortality and DALY rate of males increased by 184.29%, 148.96% and 115.16%, respectively; the morbidity, mortality and DALY rates of females increased by 160.9%, 101.32% and 81.44%, respectively. The age-standardized incidence increased by 34.70%, while the age-standardized mortality and age-standardized DALY rate decreased by 3.33% and 4.02%, respectively; the age-standardized incidence, mortality and DALY rates of males increased by 39.52%, 8.03% and 3.68%, respectively; the age-standardized incidence rate of females increased by 31.40%, while the age-standardized mortality rate and age-standardized DALY rate decreased by 14.02% and 11.53%, respectively. In 2019, both the mortality rate and DALY rate due to ischemic stroke increased with age, and the highest rate was found in the population over 85 years old. Males over 60 years old were significantly than females. In the 55-84 age group, the incidence of ischemic stroke in females was higher than that in males, while in the 85 and above age group, the incidence of ischemic stroke in females was lower than that in males. The AAPC of age-standardized incidence, age-standardized mortality, and age-standardized DALY rates due to ischemic stroke from 1990 to 2019 were 1.06% (95%CI 1.00% to 1.11%), 0.01% (95%CI −0.45% to 0.48%) and −0.16% (95%CI −0.53% to 0.22%), respectively. All indicators of the AAPC for males were higher than those for females. ConclusionThe curvent age-standardized mortality and DALY rate of ischemic stroke in China have decreased slightly compared with 1990. The crude mortality, morbidity and disease burden have significantly increased. All indicators of the AAPC for males were higher than those for females. To reduce the epidemic trend and disease burden of ischemic stroke, reasonable prevention and treatment measures and rational allocation of health resources should be made according to sex and age.