<p>This study aimed to investigate caregivers’ knowledge, attitudes, and practices (KAP) regarding secondary stroke prevention in individuals with ischemic stroke. A cross-sectional survey was administered once per participant during the recruitment period from March 26, 2024 to March 27, 2025 across five hospitals in Sichuan Province, using a standardized questionnaire to gather data. Participants’ demographic information was recorded, and KAP scores related to secondary stroke prevention were assessed. A total of 589 valid questionnaires were analyzed. The majority of participants were female (63.0%), lived in urban areas (70.6%), and had at least an associate degree (34.8%). The scores for knowledge, attitude, and practice were 10.85 ± 4.61 (possible range: 0–22), 34.66 ± 4.82 (possible range: 10–50), and 38.51 ± 6.06 (possible range: 10–50), respectively. Correlation analysis revealed significant positive relationships between knowledge and practice (<i>r</i> = 0.123, <i>P</i> = 0.003) and between attitude and practice (<i>r</i> = 0.338, <i>P</i> &lt; 0.001). However, the correlation between knowledge and attitude was not significant. Structural equation modeling indicated that knowledge directly affected practice (β = 0.140, <i>P</i> = 0.032), and attitude also directly affected practice (β = 0.253, <i>P</i> = 0.016). Overall, caregivers reported lower knowledge scores and less favorable attitudes, while practice scores were comparatively higher within the observed range. Both knowledge and attitude had a direct effect on caregiving behaviors.</p>