Ischemic stroke, as a major cause of disability and mortality worldwide, has a complex pathophysiological mechanism. However, current treatments such as intravenous thrombolysis and mechanical thrombectomy remain limited by narrow time windows and restricted eligibility. Therefore, it is urgent to explore new intervention targets. In recent years, circular RNA (circRNA) has gradually become a promising focus in the diagnosis and treatment of ischemic stroke due to its high stability, tissue specificity, and ability to regulate multiple pathways. Therefore, this article summarizes the regulatory role of circRNA in key links such as regulating astrocyte function and neuronal inflammatory injury, regulating apoptosis and ferroptosis, regulating cerebrovascular function and post-stroke vascular repair, and influencing endothelial cell function and blood-brain barrier integrity, in order to guide further research and explore new therapeutic targets for improving ischemic stroke.