Abstract Background Significant association between bullous pemphigoid (BP) and stroke has been reported. This study aimed to evaluate the level of anti-BP180 antibody in stroke patients to explore the relationship between BP and stroke in their pathogenesis. Methods We collected serum samples from stroke patients and matched controls between February 2019 and June 2020. The anti-BP180 antibody levels were measured by enzyme-linked immunosorbent assay (ELISA). Results A total of 1183 stroke patients including 970 with cerebral infarction (CI), 192 with intracerebral hemorrhage (ICH), 21 with CI and ICH, and 855 controls were enrolled in this study. Anti-BP180 autoantibody values were significantly higher in stroke patients than in controls (p < 0.001). Anti-BP180 autoantibody-positive rates were 12.51% (148) in stroke patients and 4.68% (40) in controls (p < 0.001, OR = 2.65). In anti-BP180 autoantibody-positive subjects, the values were significantly higher in stroke patients than in controls (p < 0.001). However, only 10 (6.76%) stroke patients and 3 (7.5%) controls had high values (> 100 RU/mL) (p = 0.87). Stratified analysis showed that anti-BP180 antibody positive rates were independent of age, sex, and stroke subtypes in the stroke group. Positive rates in patients with both CI and ICH were nearly two times higher than those in patients with either CI or ICH alone (p = 0.11, OR = 1.94). Study limitations This study had a limited sample size and lacked quantitative criteria for stroke severity. Conclusions Anti-BP180 antibody values and positive rates were higher in stroke patients than in controls, suggesting that stroke patients may have higher of developing BP. (BP reported antiBP180 antiBP anti BP180 anti-BP18 pathogenesis 201 2020 enzymelinked enzyme linked ELISA. ELISA . (ELISA) 118 97 CI, , (CI) 19 (ICH) 2 85 AntiBP180 AntiBP Anti Anti-BP18 p 0.001. 0001 0.001 0 001 0.001) autoantibodypositive 1251 12 51 12.51 148 (148 468 4 68 4.68 40 (40 2.65. 265 2.65 65 2.65) subjects However 1 6.76% 676 6 76 (6.76% 7.5% 75 7 5 (7.5% > ( RU/mL RUmL RU mL 0.87. 087 0.87 87 0.87) age sex group 011 11 0.11 1.94. 194 1.94 94 1.94) severity antiBP18 BP18 anti-BP1 20 202 (ELISA 9 (CI (ICH 8 AntiBP18 Anti-BP1 000 0.00 00 125 12.5 14 (14 46 4.6 (4 26 2.6 6.76 67 (6.76 7.5 (7.5 08 0.8 01 0.1 1.9 antiBP1 BP1 anti-BP AntiBP1 Anti-BP 0.0 12. (1 4. 2. 6.7 (6.7 7. (7. 0. 1. 6. (6. (7 (6