Abstract : Stroke is the second leading cause of both disability and death worldwide, with the highest burden of the disease shared by low and middle-income countries. Over the last decade, there has been a significant rise in patients hospitalized for stroke with HIV infection. This has important public health and socioeconomic consequences. HIV is independent risk factor for ischemic strokes. This study was conducted to find out correlation between HIV patients & ischemic strokes patients of western Maharashtra. To study different etiology of stroke in HIV patients admitted in a tertiary care teaching hospital. This observational study was conducted in department of medicine from March 2021 to June 2022 to study different etiology & correlation of HIV patients in ischemic stroke. Ten stroke patients with HIV admitted in the medical ICU were studied. 9 with ischemic infarctions (90%) and 1 with intraparenchymal hemorrhage (10%). Mean age was 42 years (range 23 to 72), 7 patients (70%) were male. Nine patients had a previous diagnosis of HIV infection (90%) and 1 patients were diagnosed during the acute stroke evaluation (10%). Mean CD4 count at the time of stroke diagnosis was 116 cells/mm3 (range 2 to 659); 8 patients (80%) had CD4 count ≤200 cells/mm3 and 5 (50%) had CD4 count ≤100 cells/mm3.Antiretroviral therapy had been used by 6 patients (60%), including 3 patients (30%) who were on CART at the time of the stroke. Tobacco use was the most prevalent traditional vascular risk factor (50%), followed by hypertension (40%). Anticardiolipin antibodies were investigated in 3 patients (30%) and found in 10% of these cases. 4 patients (40%) with non-atherothrombotic strokes had been exposed to antiretroviral agents when the stroke occurred. There were no also differences in CD4 counts at the time of the stroke between the atherothrombotic and non-atherothrombotic groups. Patients with unfavorable outcome (death or severe disability) had a lower CD4 count. All patients had poor prognosis with CD4 count ≤100 cells/mm3 (mean 22.6 ± 20.3). Stroke in HIV patients had independent risk factor as being immunocompromised. CNS vasculitis being the most common mechanism for causal of the stroke. Hypertension, dyslipidemia, metabolic syndrome, smoking were other significant risk factors. 20% patients with stroke had only HIV as a risk factor.