Background: Among the estimated 20% to 40% of stroke survivors who develop spasticity, the burden of this condition on patients, caregivers, and society is substantial. Aim: To determine the level of activities of daily living (ADL) among patients with paralysis. Materials and Methods: In this study conducted descriptive research design. We collected data from 138 post stroke patients, between January and April 2024. The activities of daily living (ADL) assessed by Barthel index Scale. Research approval was obtained from the research ethics committee of the Mongolian National University of Medical Sciences (approval no. 03/2023) This research using purposive sampling from three in public tertiary care hospitals in Mongolia. Sample size calculated using 3G power analysis and data were analyzed using descriptive statistics. p<0.05 considered as a significant level. Result: Most of the participants were female (46.4 %) and male (53.6 %) mean age with an average of (50.914.3) As results, the mean of the Barthel index was (37.02±22.43). Assessment of activities of daily living using the Barthel Index revealed that 76 patients (55.1%) had impaired ADL performance. Conclusion The findings indicate that patients with paralysis have limited self-care ability and require caregiver assistance to perform activities of daily living