Despite reductions in major adverse events with the latest generation of left ventricular assist devices (LVADs), the incidence of stroke remains high. The timing of anticoagulation resumption is controversial. We aim to explore practices of anticoagulation management following ischemic stroke in LVAD patients and identify optimal strategies. We retrospectively analyzed our LVAD database between 11/2012 and 5/2018. Patients who suffered ischemic stroke were categorized into 3 groups based on the timing of anticoagulation resumption post-stroke: anticoagulation immediately continued (A), held 1-4 days (B), held >4 days (C). Primary outcome events included recurrent ischemic stroke or TIA, pump thrombosis, systemic thrombosis, and intracranial or extracranial bleeding within 90 days. Descriptive and nonparametric survival analyses were performed. Of the 38 patients identified as having an ischemic stroke, 22 experienced 37 primary outcomes including 5 recurrent ischemic strokes/TIAs, 3 pump thromboses, 15 systemic embolic events, 9 intracranial and 5 systemic hemorrhages. We found no significant association between timing of anticoagulation resumption and incidence of subsequent ischemic events (Group A= 39%, B= 22%, C= 17%) or intracranial bleeding (Group A= 17%, B= 33%, C= 33%). Kaplan-Meier survival free of a primary outcome for all patients was 65%, 56% and 50% at 7, 14 and 30 days post ischemic stroke, respectively. There was no association between survival and timing of anticoagulation, sex, LVAD type or placement before vs after 2014. We found a high rate of early outcomes after ischemic stroke in LVAD patients, with no evidence of increased risk with continued anticoagulation. Accepting the limitations of a retrospective study, these data suggest that anticoagulation may not need to be held acutely to prevent hemorrhagic conversion. Risk factors for these post ischemic stroke outcomes however were not identified. Further research is needed to identify approaches to decrease these secondary complications.