Objective To analyze the potential profile of kinesiophobia in stroke patients with hemiplegia and the influencing factors of different profile categories. Methods From June 2024 to January 2025，convenience sampling was used to select 247 stroke patients with hemiplegia in the Neurology Department of a Class Ⅲ Grade A hospital in Hebei Province as the participants. The general information questionnaire，Tampa Scale for Kinesiophobia，Exercise Self-Efficacy Scale，Perceived Social Support Scale，and Exercise Barriers Scale were used to investigate. Latent profile analysis and multiple Logistic regression were used to analyze the latent profile of kinesiophobia and its influencing factors in stroke patients with hemiplegia. Results Among the 247 stroke patients with hemiplegia，170 cases（68.8%） had kinesiophobia. The results of latent profile analysis showed that the kinesiophobia of stroke patients could be divided into three latent categories：autonomous regulation - exercise adaptation group（C1，38.5%），pain dominated-exercise caution group（C2，35.6%），and injury sensitivity - exercise avoidance group（C3，25.9%）. Compared with C1，patients without a history of falls in the past year and those with higher scores of perceived social support were less likely to be classified into C2 and C3；patients with higher pain scores at admission were more likely to be classified into C2；patients with higher scores of exercise self-efficacy were less likely to be classified into C2； patients with higher scores of exercise barriers were more likely to be classified into C2 and C3（P<0.05）. Conclusion The incidence of kinesiophobia in stroke patients with hemiplegia is high，and there is heterogeneity. Medical staff should carry out precise interventions according to the characteristics and influencing factors of different groups to reduce the level of kinesiophobia in stroke patients with hemiplegia and improve the effect of exercise therapy.