Objective To investigate the serum level of NT-pro-BNP in patients with acute ischemic stroke and to determine whether NT-pro-BNP levels were associated with the death within 15 days of stroke onset. Methods Two hundard twenty-six consecutive patients with acute ischemic stroke within 48 hours of onset were enrolled in this study. We measured plasma NT-pro-BNP within 72 h and recorded the NIHSS score on admission. Patients were divided into two groups: the deceased group, who died within 15 days, and the survival group. The factors associated with the death within 15 d of stroke onset were investigated by using multivariate logistic regression analysis. Results Twenty-four (10.6%) patients died with 15 days of stroke onset. The incidence of atrial fibrillation, cardioembolism and large infarc?tion, the mean ± SD of NIHSS score, age, glucose level and creatinine were significantly higher in the deceased group than in the survival group (P<0.001). On the other hand, the mean ± SD of LVEF, albumin, LDL-C, and total-cholester?ol were significantly lower in the deceased group than in the survival group(P<0.05 ). The median of the plasma NT-pro-BNP level was significantly higher in the deceased group than in the survival group (2598.5 vs. 190.4 pg/mL, P<0.001). The optimal cut-off level, sensitivity, specificity and ROC area of NT-pro-BNP levels to distinguish the de?ceased group from the survival group were 955.2 pg/mL, 83.3%and 82.2%, 0.906, respectively. Binary logistic regression analysis demonstrated that NIHSS score of ≥13 (OR=56.18, 95% CI=9.06 to 348.40, P =0.000) , plasma Lg NT-Pro-BNP level (OR=38.79, 95%CI=6.52 to 230.95, P=0.000) , and the size of infarction (OR=8.73, 95%CI=1.11~68.88, P=0.040) were independent factors associated with the death within acute phase of stroke. Conclusions The plas?ma NT-pro-BNP level can predict the death of stroke patients within 15 days of stroke onset.