Objective To analyze the clinical characteristics of vasovagal syncope patients and to discuss if they exhibit factors affecting the existence of presyncope. Methods Patients with vasovagal syncope admitted to Beijing Tiantan Hospital, Capital Medical University from January 2017 to June 2022 were included retrospectively. Their general data, results of head-up tilt test and hemodynamic indexes were collected. Multivariate logistic regression analysis was used to explore the influencing factors of presyncope. Results A total of 1211 patients with vasovagal syncope were included in the study. The patients were divided into two groups according to the presence or absence of presyncope, with 582 (48.06%) cases in the non-presyncope group and 629 (51.94%) cases in the presyncope group. There were statistically significant differences in the following factors between the two groups: age (t=6.006, P<0.001), number of female (χ2=11.749, P=0.001), BMI (t=2.562, P=0.011), and history of hypertension (χ2=12.643, P<0.001), diabetes (χ2=9.129, P=0.003) and cerebral vascular disease (χ2=4.060, P=0.044). There was no significant difference in the results of head-up tilt test between the two groups (χ2=6.205, P=0.102). Multivariate logistic regression analysis showed that age≤60 years (OR=1.727, 95%CI 1.347-2.214, P<0.001) and being a female (OR=1.440, 95%CI 1.122-1.847, P=0.004) were the risk factors of presyncope. Conclusions Vasovagal syncope patients with≤60 years of age and female are more likely to have presyncope before syncope. This may be related to the function of autonomic nervous regulation . [ABSTRACT FROM AUTHOR]