The purpose of the work was to describe the symptoms of alien hand syndrome (AHS) in patients with acute ischemic stroke (IS). We examined six (6) patients with AHS that was the earliest symptom of acute IS in all patients. In four patients ASH syndrome manifested together with the feeling of coldness and hypoesthesia in the same arm. All known types of AHS (frontal, callosal, sensory) were seen with prevalence of frontal type (in 4 of 6 patients). AHS occurred in patients with massive stroke predominantly in right hemisphere. All cases of AHS were associated with pathological process in parietal lobe. In five patients ischemic focus spread in subcortical structures (to basal ganglia in 4 patients and to corpus callosum – in 1 patient). The patients were frightened of AHS and in all cases AHS was associated with kinesthetic (ideomotor) apraxia. AHS had a transient course and regressed during the acute period of IS. The sense of «extraneity» persisted longer than involuntary movements in hand.