Background and Objective: Uric acid is a neuroprotective agent. However, its relationship with ischaemic stroke remains controversial. We analyzed the association between serum uric acid and ischemic stroke and clinical outcome. Methods: The study subject consisted of 550 ischemic stroke patients from the Nizam’s Institute of Health Sciences, Hyderabad, India with 550 matched healthy controls. Serum uric acid levels were estimated, and follow-up interviews conducted with patients. Results: There was a significant association of elevated levels of serum uric acid with stroke and its subtypes except lacunar stroke. Patients with high serum uric acid levels had a significant increased risk of poor outcome. Conclusion: Serum uric acid level is associated with ischemic stroke, and is an independent prognostic factor of poor outcome.