The gastrointestinal tract is a major organ of the body that absorbs nutrients, water, and electrolytes. At the same time, it is a tight barrier that resists the invasion of harmful substances and maintains the homeostasis of the internal environment. Destruction of the intestinal barrier is linked to the digestive system, cardiovascular system, endocrine system, and other systemic diseases. Mounting evidence suggests that ischemic stroke not only changes the intestinal microbes but also increases the permeability of the intestinal barrier, leading to bacterial translocation, infection, and even sepsis. The intestinal barrier, as part of the gut-brain axis, has also been proven to participate in the pathophysiological process of ischemic stroke. However, little attention has been paid to it. Since ischemic stroke is a major public health issue worldwide, there is an urgent need to know more about the disease for better prevention, treatment, and prognosis. Therefore, understanding the pathophysiological relationship between ischemic stroke and the intestinal barrier will help researchers further uncover the pathophysiological mechanisms of ischemic stroke and provide a novel therapeutic target for the treatment of ischemic stroke. Here, we review the physiology and pathology between ischemic stroke and intestinal barrier based on related articles published in the past ten years about the relationship between ischemic stroke, stroke risk factors and intestinal flora, and intestinal barrier. We further discuss the following parts: the intestinal barrier, possible mechanisms of intestinal barrier destruction in ischemic stroke, intestinal barrier destruction caused by stroke-related risk factors, intestinal barrier dysfunction in ischemic stroke, targeting the intestinal barrier for improving stroke, conclusions and perspectives.