Background: Intravenous alteplase is a drug treatment administered as an emergency measure within the early hours of patient admission. Objectives: This study aimed to determine the role of hyperdense signal length in the middle cerebral artery on the degree of disability in patients with arterial ischemic stroke who exhibit evidence of vascular involvement. Methods: In this cross-sectional study, patients with stroke who were referred to the emergency department of Imam Hossein Hospital in Tehran were included. The tools used were the demographic profile form and the Modified Rankin Scale (mRS). At the time of admission, the demographic profile form and the mRS tool were completed. The mRS tool was then administered again at discharge and 3 months after discharge. Following data collection, the patients' information was entered into SPSS version 16 software for analysis. Results: The results showed that there was no relationship between the patient's age and the disability score at admission (P = 0.11). However, at discharge and 3 months after discharge, the level of disability had a significant relationship with the patient's age, with younger patients reporting less disability. Additionally, after admission and thrombectomy, the patient's disability status significantly improved compared to the status at admission (P = 0.000). The mean ± SD mRS score at admission was 4.78 ± 0.44, while at discharge it was 3.94 ± 1.84. The mean ± SD disability score 3 months after discharge decreased from 4.78 ± 0.44 to 3.72 ± 2.25. This reduction compared to the discharge score was not statistically significant (P = 0.06). Conclusions: Older patients and those with higher middle cerebral artery (MCA) levels reported greater disability. Therefore, it is necessary to implement preventive measures to address this issue.