A history of systolic (≥ 160 mm Hg) or diastolic (≥90 mm Hg) hypertension, diabetes mellitus (fasting venous plasma glucose ≥140 mg/dl), a history of cigarette smoking, fasting serum total cholesterol ≥200 mg/dl and ≥250 mg/dl, and obesity (≥20% above ideal body weight) were examined as risk factors for atherothrombotic brain infarction (ABI) in 144 men, mean age 81 ± 8 years, and 391 women, mean age 82 ± 8 years, in a long‐term health care facility. ABI occurred in 33 of 144 men (23%) and in 68 of 391 women (17%), P not significant. A history of systolic or diastolic hypertension correlated with ABI in both men and women (P<0.001). Diabetes mellitus correlated with ABI in both men and women (P<0.001). A history of cigarette smoking correlated with ABI in men (P<0.02) but not in women. Serum total cholesterol ≥200 mg/dl and ≥ 250 mg/dl did not significantly correlate with ABI in men or in women. Obesity did not significantly correlate with ABI in men or in women. Systolic or diastolic hypertension, diabetes mellitus, and cigarette smoking are risk factors for ABI in elderly men. Systolic or diastolic hypertension and diabetes mellitus are risk factors for A