Objective To compare whether the differences existed of collateral circulation in patients with acute anterior circulation intracranial large vessel occlusion induced by large artery atherosclerosis (LAA) and cardioembolism (CE) stroke, and explore the influencing factor to collateral circulation. Methods A total of 70 patients with acute ischemic stroke induced by anterior circulation intracranial large vessel occlusion, admitted to the Second Hospital of Lanzhou University, were retrospectively collected from January 2020 to August 2021, and divided into LAA group (n=50) and CE group (n=20) based on the etiological classification of stroke. The baseline data of the two groups were compared, and CT angiography iconography data were used to score the collateral circulation. On a 3-point scale, the collateral circulation scores were dichotomized into poor (grade 0 or 1, n=31) vs. good (grade 2 or 3, n=39), the clinical data of the two groups were compared, and multivariate logistic regression analysis was performed to determine the independent risk factors for collateral circulation. Results The proportion of good collateral circulation was higher in LAA group than that in CE group(64% vs. 35%, P=0.027), and the proportion of the thrombus load score (CBS) ≥6 and admission systolic pressure was also higher in LAA group than those in CE group (P<0.05). The score of US. National Institutes of Health Stroke Scale (NIHSS) at admission was significantly lower in LAA group than that in CE group [5.50(3.00, 10.00) vs. 13.50(8.25, 17.00), P=0.003]. The proportion of LAA was higher, while of previous hypertension and diabetes history and NIHSS score at admission were lower in good collateral circulation group than those in bad collateral circulation group with statistical significance (P=0.027, P=0.044, P=0.003, P=0.017, respectively).Multivariate logistic regression analysis showed that the etiological types of stroke were CE (OR=4.607, 95%CI 1.337-15.877, P=0.016),history of hypertension (OR=3.357, 95%CI 1.059-10.642, P=0.040) and diabetes history (OR=4.589, 95%CI 1.530-13.766, P=0.007),which were the independent risk factors for collateral circulation. Conclusions Patients with stroke due to LAA had a more extensive cerebral collateral circulation than those with CE. Etiological type of stoke was CE, the history of hypertension and diabetes, are the independent risk factors for the poor collateral circulation in patients with acute anterior circulation intracranial large vessel occlusion.