Background: Leptin is a major adipokine that regulates weight balance and energy homeostasis. The present study was conducted to assess serum leptin level and the risk of ischemic stroke. Materials & methods: 65 patients with first ever-ischemic stroke of both genders (Group I). Equal age- and sex-matched subjects were included as controls (Group II). 5 ml venous blood was collected and erythrocyte sedimentation rate (ESR), white blood cell (WBC), fasting blood glucose, total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, triglycerides, and leptin levels was measured Results: The mean age in group I was 54.2 years, in group II was 54.6 years, BMI was 26.5 Kg/m2 in group I and 22.4 Kg/m2 in group II. Blood glucose level was 110.2 mg/dl in group I and 108.4 mg/dl in group II, WBC count was 9812.4 in group I and 7814.6 mg/dl in group II and ESR was 36.2 in group I and 15.3 in group II. Total cholesterol was 184.2 mg/dl and 156.4 mg/dl, HDL was 44.5 mg/dl and 43.1 mg/dl, LDL was 120.3 mg/dl and 94.2 mg/dl, triglyceride was 145.2 mg/dl and 142.8 mg/dl, VLDL was 28.9 mg/dl and 25.7 mg/dl, CRP was 14.5 mg/dl and 5.1 mg/dl and leptin was 6598.2 pg/ml and 3012.5 pg/ml in group I and II respectively. The difference was significant (P< 0.05).Conclusion: Stroke patients had higher leptin level. Leptin may have a role in atherosclerosis mediated through inflammation.