IntroductionGlobally about 20 million people suffer from stroke each year. Stroke is a medical condition in which poor blood flow to the brain results in cell death. The risk factors causing stroke are high blood pressure, high blood, tobacco smoking, obesity cholesterol, diabetes mellitus and previous Transient Ischemic Attack (TIA).Objectives: To determine the association of stress hyperglycemia at admission with outcome of acute ischemic strokeMaterials and Methods: A study was done at Thiruvalla, Kerala for a period of one year. All new cases of cerebral infarction admitted comprised of 70 cases, 35 each in Euglycemia and Stress hyperglycemia group who were classified at the time of admission based on random blood glucose estimation with the features of stroke. All necessary investigations for the work-up of case required were done. Glasgow Outcome Score for the assessment of recovery in patients was scored, based on National Institute of Health Stroke Scale (NIHSS) on day 1, at the time of discharge and then again on day 30 to assess the clinical outcome. Standard descriptive statistics were used to report the data. Fisher's exact test and Students t test were used to compare the two groups. Binary logistic regression analysis was done.Result: Patients with stress hyperglycemia were found to have increased NIHSS scores on admission and this was more prominent at time of discharge on compared to euglycemic group. Poor recovery was associated with small and medium infarct size in stress hyperglycemia. However, prognosis worsened if size of infarct increased in both groups.Conclusion: Adequate control of blood glucose levels should be maintained immediately during admission and during follow-up to improve prognosis.Keywords: Stroke, Glucose levels, Prognosis