Objective To explore the impact of early comprehensive rehabilitation training driven by engineering assessment on the quality of life and limb function recovery of patients with ischemic stroke (IS). Methods A total of 90 patients with IS admitted to the Department of Rehabilitation Medicine of Nanjing Brain Hospital from January 2022 to December 2024 were selected and randomly divided into a control group (conventional rehabilitation, n＝45) and an observation group (conventional rehabilitation combined with early comprehensive rehabilitation training driven by engineering assessment, n＝45). The changes in stroke-specific quality of life scale (SS-QOL) scores, gait spatiotemporal parameters and balance platform quantitative indicators were compared between the two groups before and after treatment. Results After treatment, the total scores of SS-QOL and the scores of dimensions such as mobility, self-care, emotional state, and social participation in both groups were higher than those before intervention, and the improvement in the observation group was greater (all P＜0.05). The observation group also showed significantly better improvements in gait speed, step length, cadence, and gait symmetry index than the control group (all P＜0.05). The decreases in center of pressure (COP) trajectory length, mean sway velocity, and total sway amplitude were greater in the observation group than in the control group (all P＜0.05). Conclusion Early comprehensive rehabilitation training based on engineering assessment can effectively improve the gait characteristics and balance control ability of patients with IS, promote the recovery of limb function and has good clinical application value.