BackgroundHomolateral Imitative Synkinesis (HIS) is a rare form of associative movement between the ipsilateral upper and lower limbs. The incidence of HIS or its correlation with various movements remains uninvestigated. This study expounds on the characteristics of HIS, the frequency at which it occurs, and its relationship with movement, particularly walking. MethodsThis study included 1328 patients with acute stroke admitted to our healthcare facility between October 2019 and February 2022. We evaluated the severity of motor paralysis and sensory impairment in instances where HIS manifested, and assessed the relationship between HIS, basic activities, and gait. ResultsHIS was observed in 13/1328 patients. Motor paralysis was mild in all the cases. Each patient displayed a degree of sensory impairment, albeit of varying severity. HIS did not manifest during basic activities but was evident during walking movements in five instances. These patients displayed involuntary repetitive lifting of their upper limbs during the swing phase of their gait. Some individuals expressed discontent with involuntary upper-limb movements, citing them as contributors to a suboptimal gait. ConclusionsThis study identified HIS as a rare syndrome, manifesting at a rate of 0.9%. Focus was more common in patients with damage to the thalamus and parietal lobe. No manifestations of the HIS occurred during basic activities, suggesting a weak correlation between the HIS and such activities. Certain patients exhibit HIS during gait, report suboptimal gait, and have an increased risk of falls, potentially influencing their gait proficiency.