Hypothesis: There is considerable evidence that women have poor outcome following acute stroke when compared to men. We report our experience from a large prospective stroke database from Qatar. Methods: The Qatar stroke database is a prospective study, which began enrolling patients in 2014. We collected data on the demographics, clinical presentation, investigations, treatments, hospital complications and outcome (measured as 90-days modified Rankin Score [mRS]) on all patients admitted with acute stroke to the Hamad General Hospital where ~95% of stroke patients in Qatar are admitted. Multivariate analysis of risk factors, stroke type and severity, and in-hospital complications were compared to determine 90-days and one-year outcome in men and women. Results: There were 7300 stroke patients (women:1406 [19.3%], men:5894 [80.7%] admitted between 2014-2021. Multivariate analysis revealed significantly higher rates of obesity (OR 2.51), increasing age (age>65 years [OR 3.79]) and atrial fibrillation (OR 1.26) in women, p<0.001. In women, thrombolysis was less frequent and poor outcome (mRS 3-6) was more frequent (OR 1.62, p< 0.001) after adjustment for risk factors, stroke severity and in-hospital complications. The one-year mortality was significantly higher in women (11.7% versus men: 5.1%, p<0.001). Conclusions: In this large series of prospectively collected acute stroke patients from Qatar, our study reveals that women are more likely to have a poor outcome when compared to men. Although there was a higher incidence of obesity and previous CAD in women, we were unable to explain the reasons for the poor outcome at 90 days and one year.