Objective To explore the moderating effect of psychological resilience on the relationship between coping styles and depressive symptom scores in patients with acute ischemic stroke（ AIS）. Methods Convenience sampling was used to select 252 patients with AIS from January 2022 to June 2023 in the Affiliated Brain Hospital of Nanjing Medical University as study subjects. Connor-Davidson Resilience Scale （CD-RISC）， Simple Coping Style Questionnaire（ SCSQ）， and Self-Rating Depression Scale（ SDS） were used to assess the psychological resilience， coping styles， and depressive disorder of AIS patients. Pearson correlation was used to analyze the correlation between psychological resilience， coping styles， and depressive disorder. Stratified regression was used to analyze the moderating effect of psychological resilience on the relationship between coping styles and depressive symptom in patients with AIS. Results The CD-RISC score of AIS patients was（ 62.23±10.25）， with the highest mean score of（ 2.60±0.48） for the toughness dimension items. The SCSQ score was（ 28.04±5.23）， with the highest mean score of（ 1.45±0.28） for the negative coping dimension items. The SDS score was（ 52.27±10.93）. Pearson correlation analysis showed that CD-RISC scores， strength dimension scores， optimism dimension scores， and toughness dimension scores were all negatively correlated with negative coping dimension scores and SDS scores， and positively correlated with positive coping dimension scores（ r=-0.681， -0.665， -0.597， -0.504， -0.625， -0.547， -0.662， -0.612， 0.736， 0.642， 0.681， 0.709； all P ＜ 0.05）， negative coping dimension scores were negatively correlated with positive coping dimension scores and positively correlated with SDS scores（ r=-0.342， 0.517； all P ＜ 0.05）， and positive coping dimension scores were negatively correlated with SDS scores（ r=-0.552， P＜0.05）， and all of these differences were statistically significant. Stratified regression showed that the product of positive coping and toughness in model 3 was correlated with depressive disorder in AIS patients（ t=-3.587， P＜0.001）. Conclusions Coping styles are associated with depressive disorder in AIS patients， and psychological resilience plays a moderating effect between coping styles and depressive symptom scores. Positive coping styles are beneficial in reducing depressive symptom scores， and improved psychological resilience reduces the risk of depressive disorder due to coping styles in patients with AIS.