Abstract Background Early predictors of mortality and poor functional outcome are crucial for planning the level of care and optimizing resource utilization. Nonetheless, rapid and noninvasive methods for assessing the prognosis of patients with acute hemorrhagic stroke in the emergency department (ED) are currently lacking. Aim of the Work The aim of this work is to assess and evaluate the QT- prolongation in patients with acute stroke without known cardiac disease and to correlate between prolonged QT interval and different neurological outcomes. Patients and Methods This was a case control study. Data from patients with acute ischemic stroke (stroke patients) who were admitted to the neurological intensive care unit were collected for the period from June 2021 to December 2021 at the First Affiliated Ahmad Maher teaching hospital, and patients in other departments were enrolled as controls. Results This study had several limitations. First, the study was performed in a single center, which may reduce its generalizability. In addition, we were unable to determine non-fatal long-term outcomes, such as major adverse cerebro-cardiovascular events (MACCE). Second, the mechanism underlying QTc interval prolongation remains tentative because ECG was performed at single time points, not overtime. Furthermore, major cardiac and non-cardiac comorbidities were defined as the previous history and/or ECG results at admission, thus possibly underestimating subclinical conditions. In addition, the contribution of each cardiac and non-cardiac condition to QTc interval prolongation is not equally the same. We also could not absolutely exclude patients with coronary artery disease who shared similar risk factors because we did not conduct echocardiography or coronary angiography, and this may have affected the QTc interval changes in ECG. Conclusion Prolonged QTc interval was associated with the increased risk of long-term mortality, in parallel with the increasing trend of the prevalence of cardiovascular risk profiles and stroke severity, across sex differences, such as different distributions of age, comorbidities, morality, and QTc intervals in AIS patients. Acute ischemic stroke patients may have a longer QT interval and a higher incidence of electrocardiogram abnormalities. In clinical practice, careful attention should be paid to acute ischemic stroke patients to prevent malignant arrhythmia.